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Recently, I went snowshoeing with my wife and dog in West Yellowstone. The sky was so blue, the snow so white, and the scenery so perfect I had to take a picture and share it with my friends and family. No need for a fancy camera, I pulled out my cell phone, snapped a dozen photos, posted a handful on Facebook, and within seconds my friends from Mexico, Nicaragua, and Venezuela were sharing the moment with us and making comments.
Key words in the above paragraph are "sharing" and "within seconds." I was miles from a highway, hundreds and thousands of miles away from family and friends, and yet I was able to easily, instantly, share information with them.
Another scenario: One month ago my wife was changing doctors. We arrived at her appointment and the faxed medical records had once again not "gone through." They had become lost – not scanned in, not received, not filed, or one of the many unwanted outcomes that seem to be the norm of the antiquity that is "faxing." Instead of again playing the fax game, I opted to drive across town, walk into the old clinic, pick up the medical records with my hand, and drive back to the new clinic; it took about an hour. That is how slow and unreliable I find the process of faxing.
In a profession where the communication of information and data is vital to providing care, and in an age where cost management is ever on the minds of administration, we are hamstrung by fax machines, pagers, and antiquated methods of communication from the early nineties. There was an article in The Atlantic recently about how walking into a doctor’s office was like taking a trip back in time; I can relate.
Working in a tertiary center in the intermountain West, I am often taking care of patients transferred from small hospitals in Wyoming or Montana, and it seems it is the exception rather than the rule that imaging, for example, is sent with the patient. Usually there is a report of an image, but then, as a clinician, you have to decide if you want to take the word of another doctor whom you’ve never met from a place you’ve never been regarding a patient whose life might be in danger vs. reimaging. Depending on the urgency, the latter often happens, which leads to mounting costs for the medical system to absorb and increasing exposure to unnecessary radiation.
It seems that there are two main barriers to the melding of health care and modern-day technology that even the village children in Granada, Nicaragua, carry in their front pockets: the up-front costs of buying the technology, such as EMR technology, despite the likely long-term cost savings, and HIPAA. The first could be credited to Father Capitalism, the latter to Uncle Sam.
When I imagine my ideal admitting day, it would be something like my day at Yellowstone, without the snow and blue sky. I would take a call from OSH (outside hospital), and while talking to the provider I would be getting real-time images on my PC or phone. We could talk like old friends about the subtleties seen on the imaging and the way the T waves of the EKG flow on the red, checkered paper. We would bring in our colleagues from radiology and cardiology and come to a conclusion about the most likely diagnosis and the safest place for the patient.
Gone would be the nervous anticipation of a "transfer patient" whose clinical state may or may not be consistent with the report you just received and whose medical records sent may or may not just contain a stack of nursing notes without labs, imaging, or current med list. One step further in my clinical dreamland would be something akin to what happens at my dog’s veterinary office, a virtual technological paradise. A Star Trek scanner would be waved over a chip in the abdomen of my patient and instantly onto my iPhone would appear a med list, allergies to medicine, imaging, EKGs, and different files for each hospitalization, with a wonderful H and P and DC summary for each, available at my fingertips.
I understand that this will likely never happen; just the word chip would bring up images and fears of a government-run Orwellian society to many of my patients and probably most of my family; but every time I take a picture on my iPhone and share it instantly with people half a world away, I get a warm feeling in my belly that this may one day may be a reality. A boy can dream, can’t he?
Dr. Horton completed his residency in internal medicine and pediatrics at the University of Utah and Primary Children’s Medical Center in Salt Lake City in July and joined the faculty there. He is sharing his new-career experiences with Hospitalist News.
Recently, I went snowshoeing with my wife and dog in West Yellowstone. The sky was so blue, the snow so white, and the scenery so perfect I had to take a picture and share it with my friends and family. No need for a fancy camera, I pulled out my cell phone, snapped a dozen photos, posted a handful on Facebook, and within seconds my friends from Mexico, Nicaragua, and Venezuela were sharing the moment with us and making comments.
Key words in the above paragraph are "sharing" and "within seconds." I was miles from a highway, hundreds and thousands of miles away from family and friends, and yet I was able to easily, instantly, share information with them.
Another scenario: One month ago my wife was changing doctors. We arrived at her appointment and the faxed medical records had once again not "gone through." They had become lost – not scanned in, not received, not filed, or one of the many unwanted outcomes that seem to be the norm of the antiquity that is "faxing." Instead of again playing the fax game, I opted to drive across town, walk into the old clinic, pick up the medical records with my hand, and drive back to the new clinic; it took about an hour. That is how slow and unreliable I find the process of faxing.
In a profession where the communication of information and data is vital to providing care, and in an age where cost management is ever on the minds of administration, we are hamstrung by fax machines, pagers, and antiquated methods of communication from the early nineties. There was an article in The Atlantic recently about how walking into a doctor’s office was like taking a trip back in time; I can relate.
Working in a tertiary center in the intermountain West, I am often taking care of patients transferred from small hospitals in Wyoming or Montana, and it seems it is the exception rather than the rule that imaging, for example, is sent with the patient. Usually there is a report of an image, but then, as a clinician, you have to decide if you want to take the word of another doctor whom you’ve never met from a place you’ve never been regarding a patient whose life might be in danger vs. reimaging. Depending on the urgency, the latter often happens, which leads to mounting costs for the medical system to absorb and increasing exposure to unnecessary radiation.
It seems that there are two main barriers to the melding of health care and modern-day technology that even the village children in Granada, Nicaragua, carry in their front pockets: the up-front costs of buying the technology, such as EMR technology, despite the likely long-term cost savings, and HIPAA. The first could be credited to Father Capitalism, the latter to Uncle Sam.
When I imagine my ideal admitting day, it would be something like my day at Yellowstone, without the snow and blue sky. I would take a call from OSH (outside hospital), and while talking to the provider I would be getting real-time images on my PC or phone. We could talk like old friends about the subtleties seen on the imaging and the way the T waves of the EKG flow on the red, checkered paper. We would bring in our colleagues from radiology and cardiology and come to a conclusion about the most likely diagnosis and the safest place for the patient.
Gone would be the nervous anticipation of a "transfer patient" whose clinical state may or may not be consistent with the report you just received and whose medical records sent may or may not just contain a stack of nursing notes without labs, imaging, or current med list. One step further in my clinical dreamland would be something akin to what happens at my dog’s veterinary office, a virtual technological paradise. A Star Trek scanner would be waved over a chip in the abdomen of my patient and instantly onto my iPhone would appear a med list, allergies to medicine, imaging, EKGs, and different files for each hospitalization, with a wonderful H and P and DC summary for each, available at my fingertips.
I understand that this will likely never happen; just the word chip would bring up images and fears of a government-run Orwellian society to many of my patients and probably most of my family; but every time I take a picture on my iPhone and share it instantly with people half a world away, I get a warm feeling in my belly that this may one day may be a reality. A boy can dream, can’t he?
Dr. Horton completed his residency in internal medicine and pediatrics at the University of Utah and Primary Children’s Medical Center in Salt Lake City in July and joined the faculty there. He is sharing his new-career experiences with Hospitalist News.
Recently, I went snowshoeing with my wife and dog in West Yellowstone. The sky was so blue, the snow so white, and the scenery so perfect I had to take a picture and share it with my friends and family. No need for a fancy camera, I pulled out my cell phone, snapped a dozen photos, posted a handful on Facebook, and within seconds my friends from Mexico, Nicaragua, and Venezuela were sharing the moment with us and making comments.
Key words in the above paragraph are "sharing" and "within seconds." I was miles from a highway, hundreds and thousands of miles away from family and friends, and yet I was able to easily, instantly, share information with them.
Another scenario: One month ago my wife was changing doctors. We arrived at her appointment and the faxed medical records had once again not "gone through." They had become lost – not scanned in, not received, not filed, or one of the many unwanted outcomes that seem to be the norm of the antiquity that is "faxing." Instead of again playing the fax game, I opted to drive across town, walk into the old clinic, pick up the medical records with my hand, and drive back to the new clinic; it took about an hour. That is how slow and unreliable I find the process of faxing.
In a profession where the communication of information and data is vital to providing care, and in an age where cost management is ever on the minds of administration, we are hamstrung by fax machines, pagers, and antiquated methods of communication from the early nineties. There was an article in The Atlantic recently about how walking into a doctor’s office was like taking a trip back in time; I can relate.
Working in a tertiary center in the intermountain West, I am often taking care of patients transferred from small hospitals in Wyoming or Montana, and it seems it is the exception rather than the rule that imaging, for example, is sent with the patient. Usually there is a report of an image, but then, as a clinician, you have to decide if you want to take the word of another doctor whom you’ve never met from a place you’ve never been regarding a patient whose life might be in danger vs. reimaging. Depending on the urgency, the latter often happens, which leads to mounting costs for the medical system to absorb and increasing exposure to unnecessary radiation.
It seems that there are two main barriers to the melding of health care and modern-day technology that even the village children in Granada, Nicaragua, carry in their front pockets: the up-front costs of buying the technology, such as EMR technology, despite the likely long-term cost savings, and HIPAA. The first could be credited to Father Capitalism, the latter to Uncle Sam.
When I imagine my ideal admitting day, it would be something like my day at Yellowstone, without the snow and blue sky. I would take a call from OSH (outside hospital), and while talking to the provider I would be getting real-time images on my PC or phone. We could talk like old friends about the subtleties seen on the imaging and the way the T waves of the EKG flow on the red, checkered paper. We would bring in our colleagues from radiology and cardiology and come to a conclusion about the most likely diagnosis and the safest place for the patient.
Gone would be the nervous anticipation of a "transfer patient" whose clinical state may or may not be consistent with the report you just received and whose medical records sent may or may not just contain a stack of nursing notes without labs, imaging, or current med list. One step further in my clinical dreamland would be something akin to what happens at my dog’s veterinary office, a virtual technological paradise. A Star Trek scanner would be waved over a chip in the abdomen of my patient and instantly onto my iPhone would appear a med list, allergies to medicine, imaging, EKGs, and different files for each hospitalization, with a wonderful H and P and DC summary for each, available at my fingertips.
I understand that this will likely never happen; just the word chip would bring up images and fears of a government-run Orwellian society to many of my patients and probably most of my family; but every time I take a picture on my iPhone and share it instantly with people half a world away, I get a warm feeling in my belly that this may one day may be a reality. A boy can dream, can’t he?
Dr. Horton completed his residency in internal medicine and pediatrics at the University of Utah and Primary Children’s Medical Center in Salt Lake City in July and joined the faculty there. He is sharing his new-career experiences with Hospitalist News.
