What should doctors disclose to patients in the aftermath of adverse events? Does it matter if the adverse event was related to an error? Does it matter if it was preventable or not, anticipated or unexpected? Recently, I was at the Carolina Refresher Course facilitating a session on adverse events in anesthesiology. We touched on a variety of issues, but spent the most time discussing the importance of disclosure conversations.
For years, Dr. Mark Katlic wanted a more specialized surgical approach for older people. Last fall, he persuaded executives at the nonprofit health organization LifeBridge in Baltimore to take that step. The Sinai Center for Geriatric Surgery, which he directs, is one of the first to focus on elderly surgical patients, and it is already collecting information on what improves their experiences in the operating room and afterward.
Just a little over four years ago, President Obama, in his inaugural address, challenged us a nation to “wield technology’s wonders to raise health care’s quality and lower its costs.” This was an awe-inspiring, “we will go to the moon” moment for the healthcare delivery system. But the next thought that ran through the minds of so many of us who work on health IT issues was this: how were we going to get there?
An orthopedic surgeon from New York reportedly has 261 malpractice suits against him. He has been accused of performing "phantom" and unnecessary operations. If you've been following my blog, you know that I am not a big fan of lawyers. But I have to admit that one lawyer's questions about what the hospital knew about all this and why the surgeon wasn't scrutinized sooner are good ones.
I suppose that most of my surgical heroes if they were in the current system would be referred to various well-being committees. They would have to undergo gender and cultural counseling. Many might have even been suspended or had their privileges amended. But they had all passed their boards and they could all do their job.
We’ve run amok with wearing gloves in the hospital. And by “we” I mean every healthcare worker in sight. I see people putting on gloves before they’ll give a patient a clean warm blanket. This is not only ridiculous, it’s actually harmful. Here’s why.
Going through the skin, the initial cut — that’s the cataclysm, the breaking of the barrier, the crossing of the line. It’s the leap of her faith, the breaching of the wall, the stepping into space. Within moments, it’s routine, nearly generic: his insides look like mine, yours. Been there. But the primal cut, the slice through that first and last line of protection, his skin, her freckles, the fine little hairs, the vulnerable innocence.
Every so often I have an extraordinary and surprising experience with a patient—the kind that makes us both say, "Wow, we've learned something from this." One such moment occurred recently. When one gentleman arrived at the hospital for surgery, the admitting clerk asked him to pay roughly $20,000 upfront to cover the estimated balance of a simple outpatient surgical procedure.
There have been parodies of the user experience, but I believe that clinicians can successfully use Google Glass to improve quality, safety, and efficiency in a manner that is less bothersome to the patients than a clinician staring at a keyboard.
Workflows and operational processes must be modified to optimize a new tool like electronic health records. Technology changes what is feasible, and to adapt, we need to change what we do every day. To get the most out of your EHR, adopt these seven golden rules.
It is not the personal risks faced by doctors compared to pilots that kill and harm patients. It is the fact that the kinds of solutions needed in healthcare are just at the gestational stage. Facile comments that doctors don’t care as much as pilots are just plain wrong and divert attention from the steps that can and should be taken to learn from the airline industry.
We have done it. We have decreased the increase in the cost of healthcare. Let us explain. For three decades (1980-2009), the cost of healthcare has been increasing each year at an average rate of 7.4 percent — double the rate of inflation. However, over the past three years, the increase in healthcare expenditure has remained at a low 3.1 percent.
Elton John had it so, so right: “It’s sad, so sad. Why can’t we talk it over. Oh, it seems to me that sorry seems to be the hardest word.” Mistakes are all to common in medicine, but can we say the “hardest word” when we’re involved in the mistake?
At iMedicalApps we have traditionally expounded on how smart phones can help us with patient care in regards to providing Physician centric tools at bedside. These range from drug reference tools to various clinical algorithm medical apps. But there are also non-traditional methods where smartphones enable us to improve patient care at the bedside. These are subtle, but can be equally or more powerful.
In the Boston marketplace, Partners Healthcare is is replacing 30 years of self developed software with Epic. Boston Medical Center is replacing Eclipsys (Allscripts) with Epic. Lahey Clinic is replacing Meditech/Allscripts with Epic. Cambridge Health Alliance and Atrius already run Epic. Rumors abound that others are in Eastern Massachusetts are considering Epic. Why has Epic gained such momentum over the past few years?