Your health records: more like a blog, or more like Twitter?

For over a decade I traveled 30 miles south to a rural clinic along I-45 in Fairfield, Texas. There I met one of those physicians that people always think of when they think the word "doctor."

Dr. John Keller is a community icon.

Born south of this small town, he practiced medicine there for over 50 years. Now he's retired, and the community is at a loss.

Though certainly not the cause, his retirement coincided with the roll out of a new electronic medical record, or EMR (sometimes AKA EHR).

This reminded me of a story from Dr. Keller that he related to me over a decade ago. He told me that when he first went into practice records were kept on 3"x 5" note cards.

As someone who has served in various administrative capacities over the years, I've always remembered Dr. Keller's initial non-electronic medical record. And I suspected that his care was super, despite the limitations of space on that card.

Today, EMRs are becoming more and more common. There is still significant resistance from some physicians because of the lack of a unified national standard of connectivity.

That is, one system still can't talk to another.

Plus there is the cost of implementation. Some estimates put this near $60,000 per physician in a practice.

In this day of declining reimbursement it's hard for many medical practices to take the plunge and invest in this new technology.

Plus there is the whole slew of resistance remarks that range from "it'll slow down my productivity," "I'm too old to learn," "there isn't one for my specialty," and on and on.

Personally (albeit I'm a self professed techno-nerd) I haven't seen any of these problems.

We use a nice cloud based system from AthenaHealth which allows us to limit our on site technical requirements and back up, is constantly up to date, and can be accessed anywhere. Patients can even log in to check their test results, pay their bill, or ask me a question.

The electronic prescribing is phenomenal. I haven't written more than a handful of paper prescriptions in a year or so.

But even with all this technology, I'm not sure that we practice medicine any better today than Dr. Keller did fifty years ago. We just document a whole lot more information.

But is it useful?

We're pretty good at not generating a ream of electronic information every time a patient comes in. Some EMR systems accomplish this task (conventional wisdom is that it might help with coding and therefore reimbursement).

But, we chart way more than Dr. Keller ever did. I hope it's still pertinent to our patients complaint.

What's amazing to me is that as we have advanced in our technology we have become more verbose in our ability to describe it.

You could say that we are "health care bloggers" in the patients' medical record.

Whereas Dr. Keller was more like Twitter. He kept his comments to probably less than 140 characters -- and he did just fine.

So Dr. Keller may have been ahead of his time. Maybe we should "follow" him.

High Definition Video at docdano.com: the future of video blogs?

Evernote is ever useful

Constantly in search of the latest and greatest iPhone ap, I am surprised at how useful I have found Evernote.

When you find yourself living in a world where keeping track of random thoughts is necessary -- Word documents, photographs, or in fact, any item that streams across your mind -- Evernote fits the bill.

My computer documents folder had become a trash can. With papers stuck in virtually hundreds of folders and the search function limited to folder names only, Evernote allows you to create files that can be searched inside and out.

Let's see an example:

Now being challenged with creating new ideas for our "ready to be launched" video blog (MyDermGuy), I am focusing on archiving any tidbit of data that might be useful for the blog. So I was wandering around Central Market with Kristen picking up a late evening dinner-to-go when I ran across the bath salts aisle. Now Central Market is known for bulk sales. You can buy bulk coffee, candy, honey, and yes, even bath salts. So I thought "What about a video blog on the pros and cons of using bath salts?".

I remembered Evernote. I whipped out my iPhone, took a photograph of the bath salt display, and continued on my way. (You know, now that I think about it, it did appear that people were wondering why I was photographing bath salts. )

This is where the the Evernote magic begins. It will take my photograph, put it in my virtual cloud file where I can retrieve it either from my laptop or my iPhone, AND make it where I can search for it! Yes, yes...you can add "tags". But what a pain. Evernote will use OCR technology to search the upload for any text and allow THAT to be searched. So, in my picture of bath salts it found the words "bath salts" and made it part of the information.

Next time I work on a blog post all I have to remember is "bath" and it will find my photo for me.

As a plus it will also geotag the photos. This means that if I can't remember what great idea I had at Central Market, all I have to do is find the store on the map and it will link me to all the Evernotes I have archived from that location.

This is only one example. I can send emails from my computer with travel information, take photographs of restaurant menus (yes, the OCR makes these searchable), upload PDF files, and bookmark websites for later study.

I can recommend this product without reservation. The trial version is free, and the premium upgrade is only $45 per year.