I happen to be reading one of the throwaway journals I often get and came across some perplexing stuff. In the January version of the Family Practice News I saw a picture of two happy doctors (Dr. Notte and Dr Skolnik). They are often shown in this magazine because they do some writing for the rag. And they are always happy, I guess. Anyway, the title of the piece was EHR Report: The scribe in the room and the scribe in the sky and it seems to extoll some of the virtues of today’s technology. The article gently talks about “the necessity of data input into discrete fields in the chart” and “the need to efficiently and effectively input a large amount of information has presented perhaps the greatest challenge of going digital for many physicians”. Uh…ya think? They then go on to talk about transcription software, medical scribes, and lastly, something I never heard of called Augmedix. You are not going to believe this but this service has the physician wearing a small head-mounted computer that includes a microphone, camera, and transparent display. OMG! Want more? Here you go:
This allows visual and auditory data from the patient visit to be transmitted to a scribe (a real, live human) located remotely in one of Augmedix’s data centers. The scribe is “logged in” to a copy of the physician’s electronic record and documents the visit in the appropriate place in the chart. This occurs in real time, so when the physician is finished seeing the patient, the note is complete and ready to be signed off.
This is no joke. Some dude in Indiana or India could be watching you do a pap smear and is supposedly just typing away and not sharing the pictures he is seeing. Who is going to trust this? Once again it shows how we doctors will do anything to change our way of practicing medicine but we will do NOTHING to fight back against those forces (the government, the insurers, administrators, etc) who are making us change and ruining the physician-patient relationship.
Now let’s talk about our smiling doctors. They end their little education post with a kind of mission statement:
As for us, we are still typing our notes into the EHR, for now. We remain intrigued by the range of approaches that are beginning to appear, offering options for solutions that improve the quality of physicians’ lives with attention to maintaining and improving the physician-patient relationship.
Ahh, the old quality ruse. These things improve the quality of physicians’ lives and improve the physician-patient relationship? What world are these guys from? Well, at the bottom it showed me:
Dr. Notte is a family physician and clinical informaticist for Abington (Pa.) Memorial Hospital. He is a partner in EHR Practice Consultants, a firm that aids physicians in adopting electronic health records. Dr. Skolnik is associate director of the family medicine residency program at Abington Memorial Hospital and professor of family and community medicine at Temple University in Philadelphia.
Yup, one of these guys is teaching our family docs in training and the other is a “clinical informaticist”. What the hell is that? Has anyone every called him on that name before? He must have made that up. And it sure is nice that he is a partner in a firm that aids doctors in adopting EHRs. That sounds like very unbiased writing to me. No wonder why he is smiling. What a bunch of crap. Oh, I get it, that is why they call them throwaway journals. Sorry. It took me a while.