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    Posts by:

    Craig Joseph, MD

    Magic Data Lakes

    A recent POLITICO article describes how “virus hunters” (public health experts charged with tracking infectious diseases like COVID-19) are forced to use archaic, 20th century technologies to investigate cases and share their findings: fax machines and Excel spreadsheets. Granted, there is no mention of typewriters and rotary phones, but still, it’s reasonable to expect much better. So, what’s the problem? Why is it that we can withdraw money from an ATM anywhere in the world, but we can’t easily share COVID-19 lab results between hospitals located across the street from one another? In other words, why can’t healthcare information technology “interoperate”?

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    Emojis and Why Understanding Health Information Is So Difficult

    I’ve been accused of being a geek. I’m not sure why. But anyway, last week I was listening to a podcast about emojis. You know – emojis (or emoji if you prefer that as the plural): those cute little cartoony characters that are typically used in texts to convey meaning. Instead of texting the words “Thanks so much,” you can simply text 🙏. In fact, it’s possible to string together a complete dialog with a series of emojis. Imagine that some patients get a 🦠 and have to take an 🚑 to go to the 🏥. There, the patient is taken care of by a ‍👩‍⚕️ and hopefully they’ll get better and go home following safe practices and looking like 😷.

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    Healthcare IT in the Time of the COVID-19 Pandemic

    Last week, I wrote about some of the things your healthcare information technology (HIT) folks are working on with respect to the novel coronavirus (aka SARS-CoV-2 or 2019-nCoV) and the disease that it causes (COVID-19). To summarize, we’re creating and loading the proper diagnosis codes so we can accurately report and create clinical decision support (CDS) tools. We’re building the new lab tests so once they’re available, our physicians will be able to order them in the electronic health record (EHR). We’re updating order sets and inserting the new tests as appropriate. We’re modifying the patient portal to ensure patients who are at high risk of disease aren’t exposed to other patients or clinicians who aren’t properly protected. I mentioned last week that travel screen is a bit passé at this point because we are well into community spread now (meaning it really doesn’t matter so much if you’ve traveled internationally or not).

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    Implications of the Novel Coronavirus for Healthcare IT

    If you’re reading this and you’re not aware of the novel coronavirus that’s either already causing a pandemic or is about to cause a pandemic, I suggest you go back to whatever you’re doing and enjoy the bliss that must be uniquely yours. For the rest of us, I thought it might be helpful to give a quick overview of what your healthcare information technology (HIT) team is likely feverishly working on behind the scenes.

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    The Most Powerful Force in the Universe: Inertia

    Last month, UCSF researchers reported on a study wherein investigators modified the default dispense number for various ambulatory prescription opioids. The goal was to determine if researchers could adjust the prescribing habits of physicians via minimal changes in the electronic health record (EHR). And the results were . . . they could indeed modify physician prescribing trends!

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    Why Ask Silly Questions? Why Indeed

    Last week, I did something crazy: I called my cable company. Now, now, people, calm down. I predict that everyone who just read what I wrote will agree with me that my action was unhinged. If you’re my age, you think it’s insane to call the cable company because they have a reputation for hating their customers and one would only call them if one is filled with self-loathing. If you’re a youngster, you think it’s insane to call the cable company because you don’t know what that means (“Call? Like talk on the phone to another human?” “What is this thing, this ‘cable company’ to which you refer?”) Anyway, I threw caution to the wind and called them.

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    You Need a Person for That

    My high-school-aged son is taking a personal finance class, and he recently asked some good questions about my retirement plans and investments. Since I’m a super-smart adult and knowledgeable about all things, I confidently answered his initial questions. Then he started asking more involved questions, and I was forced to fall back on my go-to answer: “I don’t know, actually, but I’ve got a guy for that.” (Since my retirement advisor is male, I’m ok with the guy terminology, but from now on, I’m sticking with person.)

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    Don’t Just Do Something – Sit There!

    Hospital and medical dramas are ubiquitous on TV (For some of my younger readers, I’ll point out that TVs are things that we used to use to watch Netflix and Amazon Prime shows back before we had Netflix and Amazon Prime shows. See my OK Boomer! post for more details.) A staple of the hospital drama is the attending physician wearing scrubs and a white coat running into a patient’s room during a Code Blue. Most of us know that Code Blue (or for the cool and hip among us, simply a “code”) is an alert that goes out throughout the hospital notifying clinicians that a patient’s heart has stopped beating. When a code is called via the overhead speakers, assorted clinical folks rush into the room to start CPR, insert a breathing tube, and give medications to try to revive the patient. It’s quite intense.

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    Do our EHRs Need a Touch Bar?

    I’ll admit it. I’m just gonna put it out there: I’m an Apple fan boy. Ok? It’s out there. I love everything about Apple: their no-nonsense aesthetic; their hardware and software connections; even their headquarters building in Cupertino, California. I think Apple is cool. Does my fascination with all things Apple mean that I overlook their warts and sub-optimal output from time to time? Yeah, to some extent, that’s exactly what it means!

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    Sometimes More Tech Is Not the Answer

    Back when I was in medical school – a million years ago – students spent hardly any time in the hospital or working with patients until their third year. My third year began on July 1, and on that date, I found myself rounding on the colorectal surgery service of a huge hospital. Jokes aside, beginning my real medical training with surgery was quite the plunge into healthcare. While I had a ton to learn about surgically related diseases and treatment, understanding what I could and could not touch in the operating room was among the most important lessons to master. After surviving a few days in the OR, I moved onto more essential preparation for a clinical career.

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