By Robert Wachter
For the earlier few a long time, know-how has been touted because the medication for all of healthcare's ills, but drugs stubbornly resisted computerization-- earlier. thank you mostly to billions of greenbacks in federal incentives, healthcare has eventually long past electronic. Wachter examines healthcare on the sunrise of its laptop age, and exhibits how expertise is altering care on the bedside. He questions even if executive intervention has been precious or destructive-- and does so with readability, perception, humor, and compassion. Read more...
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Extra resources for The digital doctor : hope, hype, and harm at the dawn of medicine's computer age
And this was not a mere gentlemanly professional dispute. Not only was he drummed off the staff of Massachusetts General Hospital, but in 1914, one surgical colleague, Dr. ” While the idea of using the medical record to measure the quality of care was important (and, as Codman learned painfully, threatening to many doctors), for generations there was very little skin in that particular game. indd 36 2/12/15 12:43 PM Strangers at the Bedside 37 century would pass before Codman’s dream of public reporting of outcomes by both physicians and hospitals became a reality, and payment for both groups came to turn on these measurements.
Today, when I take care of a patient in the hospital, my fees are governed by a strict set of guidelines that range from arcane to ridiculous (the same would be true for office visits). After I see a patient, the patient’s insurer (Medicare, Aetna, or any of a dozen others, each with slightly different but equally annoying rules) decides how much to pay the hospital, and me, based entirely on my note. ” Since a busy doctor might have 2,500 visits in a year, we’re talking about real money. While the idea of reimbursement based on patient complexity is reasonable, in practice it creates a number of troubling side effects that play out in the chart.
He discovered them cloistered in a windowless room, sitting shoulder to shoulder, each facing a glowing computer screen. The room reminded him of a vault. “It could have been in Alaska,” he said. “I sensed some reluctance on the part of the residents to go out and see the patients. And I had a similar reluctance about being in that room. ” I wondered if he blamed his residents for choosing to isolate themselves this way. His answer was characteristically charitable. To him, the residents, like the patients, were victims of the system.