===== The Digital Doctor =====

==== EHR ====
c: 2017-06-27

  * US EHR "market failure" - "Systemic, not communal", "need government standard" -- government intervention
  * "Free isn't cheap enough" Kocher - on Wellpoint's free computers to California doctors
  * "Shovel ready"
  * p14 "You never want a serious crisis to go to waste" Rahm Emanuel COS to Obama

====Radiology Rounds====
c: 2017-07-06

  * Larry Weed Emory: SOAP 1970s
  * Mayo clinic executive screening story - cellophane tape
  * Southwest airline "relational coordination"
  * information vs knowledge
  * Paul Chang: "We have to go beyond isolating ourselves and concentrating on messages in a bottle"
  * Radiology & PACS - prescient for other specialties?

==== Open Notes====
> "Doctors are conservative and hate change"

> "We would have to use a mixture of seduction and coercion"
Delbanco p.176

> "Patients possess a body of knowledge about themselves that we can never hope to master, and we have a body of knowledge about medicine that they can never hope to master"
p.173

Parasuraman automation quote p.135

> "We failed to remember the Google Mantra that it is much more important to solve a small problem incredibly well than a big problem 80% of the way."
p.186 Roni Zeiger

Personal health record - needs to  be really simple for consumer

Santa Barbara Health Information exchange failure
  * no private money interested in rare public good.


hx - 2017-07-19

==== A vision for Health information delivery ====
  * fewer hospitals and inpatients
  * change consults and records
    * [[co:ehr|EHR]] in cloud? how about curation?

> "Reaching the ideal future state will depend on government assuming its proper role: the meaningful - and limited - use of its vast powers."
p.266
 
  * 2017-08-08

==== A community of patients ====
2017-07-27
p.201

Roni Zeiger & Giles Frydman - Smart patients website

Ch 23 Meaningful Use
  * HiTECH Stages 1-3 Blumenthal
  * "Experience hath shewn that even under the best forms of government, those entrusted with power have, in time, and by slow operations, perverted it into tyranny"
  * David Brailer: "Bureacracies don't retrench," he said. "When a bureaucracy that starts as the candy man runs of out candy, it goes dark and turns into regulatory man."

==== Chapter 6 The Productivity Paradox ====
c: 2017-08-08

> What do you call a 99-1 vote of the medical staff? -- a tie

p 244 Paul Krugman: "Productivity isn't everything, but in the long run it is almost everything."

Brynjolfsson 1993: "the second machine age" , "productivity paradox"
  * "a shortfall of evidence is not evidence of a shortfall"
  * The need to redesign work with introduction of IT

> "If the doctor thinks there might be even the tiniest bit of incremental value, why wouldn't she reorder the test?"
p 248 Julia Adler-Milstein

> "Culture eats strategy for lunch"
Drucker

==== Source ====
Wachter, R. M. (2017). The digital doctor: Hope, hype, and harm at the dawn of medicine’s computer age. McGraw-Hill Education.

==== History ====
  * 2017-08-08 created on index card
  * 2020-08-10 transcribed to dokuwiki