UnChartThe Clone Wars – The Death of the Template? Definition Cloned – To produce a copy of; imitate closely Most of the EMRs we use today have templates, macros and/or the ability to copy and paste previous notes into current notes. The EMR I use can do all of the above. These options can help [...]
Archive for the ‘theory’ Category
Leadership or whining?
First, some background. A few days ago, the AAFP released a statement against expanding roles for Nurse Practitioners. The tagline: Ensuring a quality, physician-led team for every patient. One Page AAFP Infographic Nurse practitioners have started to respond. CKRN wrote about Nurse Practitioners, Scope of Practice and turf. (Go ahead and read it, I’ll wait [...]
Consultation Theater
A while back a college friend turned me on to Strengthsfinder. My strengths are Strategic, Ideation, Input, Learner and Self-Assurance. I can identify with other strengths but these fit, too. Ideation is Strengthsfinder terminology for a person who loves coming up with and thinking about ideas. That’s definitely me. Our group is starting to think [...]
Practice Improvement 3.2012 Podcast
Thanks to everyone who participated. I learned a lot about hosting a webex. The more I edited myself out of the podcast, the bettter it gets. Load in iTunes: There’s some sweet nuggets in here. So load it into your phone and listen during your commute.
Practice Improvement Webinar 2012
“The future is already here — it’s just not very evenly distributed.” —William Gibson The Basics What: Practice Improvement Webinar hosted by UnChart for e-MDs users. How: Roundtable discussion of participants about attempts at practice improvement. When: Friday, March 23, 2012. When: 10am -12pm Pacific; 11am – 1pm Mountain; 12pm – 2pm Central; 1pm – [...]
Health Information Exchanges
I’ll be helping min-ns.org to set up our local HIE. As part of that, I’ve been focusing on the message for doctors about Health Information Exchanges (and Meaningful Use and EHRs). I’m especially proud of my video about what a HIE is — I humbly submit this is the best video on the Internet about [...]
Usability of the Washington State Prescription Monitoring Program
The idea of the prescription monitoring program (PMP) rocks. Given that multiple controlled substances are potentially lethal, a prescriber or pharmacist should be able to verify other prescriptions. Transparency improves care. But it’s implemented with unnecessary friction. This is going to reduce how many busy docs or pharmacists are willing to go through the hassle. [...]
Journey to Meaningful Use
Journey to Meaningful UseView more presentations from Jonathan Ploudre. What if you’re starting out? Here’s my philosophical overview of how to achieve meaningful use for WIREC’s Meaningful Use Best Practices Forum. Here are the thoughts that go with the slides: In 2008 only 1/5 ambulatory practices have an EMR and 1/25 have a ‘full’ EMR. [...]
Deskilling
A recent study hits too close to home: “Deskilling and adaptation among primary care physicians using two work innovations” says, essentially, that as primary care docs try to use innovation like EHRs and clinical guidelines, we become less trustworthy to our patients, less confident. Or as I’ve put it elsewhere here: I don’t want to [...]
Opioid Treatment Agreement
Treatment Agreement I am being prescribed “controlled medications”. These may relieve pain but could cause overdose or become habit forming. It is my doctor’s duty to make sure these medications are being used as safely as possible and as intended. I will ask for refills only from my primary doctor. I will use only one [...]
Approaching the practice of using an EHR
Here’s a ~15 minute video about getting better at using an EHR. Well, not really. It is about being creative but this idea of an ‘OK plateau’ and conscious learning fits with every doctor I known who has learned and EHR. After you get on autopilot, you just do the same thing over and over [...]
Patient-centered Health IT Manifesto
If we are going to really get Health IT, we need to be patient-centered. It’s generally being ignored now. Modern health is phenomenal: Public Health/Sanitation/Antibiotics. Now 7% of Wealthy vs 36% of Poor die of infection in 2011.– National Geographic With modern medicine, much of main causes of death can be modified/prevented/managed by medications. Heart [...]
Interuptions and Practice
Multitasking is generally a myth. People think they can multi-task but the reality is that all the tasks they are doing are taking a hit. In an article in Time magazine 97.5% of the general population are not successful at multi-tasking. So when faced with two tasks at once, say Driving and Texting, we’re more [...]
Ambulatory Blood Pressure Monitor (Where’s Innovation?)
In 2003, JNC 7 recommended Ambulatory Blood Pressure Monitoring (ABPM) for a number of clinical situations: Suspected white-coat hypertension in patients with hypertension and no target organ damage Apparent drug resistance (office resistance) Hypotensive symptoms with antihypertensive medication Episodic hypertension Autonomic dysfunction Show me the money…. One of the main critiques was that it increased [...]
Simvastatin (Zocor) 80mg Report
Simvastatin Report Last year in March, the FDA fired a warning shot about the increased risks with the 80 mg dose of simvastatin. FDA Warning, March 2010 So last year at the e-MDs user conference I used that as an example of how to do a quick and dirty report from crystal see the video [...]
