Dr. Lisa Rosenbaum has an excellent piece in the NEJM this week entitled Transitional Chaos or Enduring Harm? The EHR and the Disruption of Medicine. In essence a review of Dr. Robert Wachter’s book The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age, it deals with the ever increasing intrusion of… Continue reading Reining in the EHR Monster
Author: mannd
I am a retired cardiac electrophysiologist who has worked both in private practice in Louisville, Kentucky and as a Professor of Medicine at the University of Colorado in Denver. I am interested not only in medicine, but also in computer programming, music, science fiction, fantasy, 30s pulp literature, and a whole lot more.
Prank Calling Kurt Gödel
Prank calling used to be a common, albeit annoying, form of entertainment back in the days when I grew up, before the invention of caller ID ruined it forever. Some prank calls were just simple and stupid jokes, such as the “do you have Prince Albert in a can?” call. On a slightly more elevated level… Continue reading Prank Calling Kurt Gödel
Pirates of Space
Ed note: I wrote this post to provide some back story/rationale for my forthcoming (maybe) starship simulator app based on the Lensman series of Edward E. “Doc” Smith. I wanted to provide some exposition updating Smith’s pioneering use of the concept of “inertialess drive” in light of current physics. This opening parallels the opening of… Continue reading Pirates of Space
Why Electronic Health Records Will Not Get Better
Today I read an article in Politico entitled “Doctors barred from discussing safety glitches in U.S.-funded software.” The article states that, despite massive public funding of Electronic Health Records (EHR), the EHR corporations (including Epic Systems, Cerner, Siemens, Allscripts, eClinicalWorks and Meditech) routinely attach gag clauses to contracts with the hospitals and medical groups who… Continue reading Why Electronic Health Records Will Not Get Better
You Can’t Tell the Batters Without a Scorecard
If you want to know who the best surgeon in the hospital is, ask the surgical nursing staff. If you want to know who does the best job opening up coronary arteries using catheters, balloons, and stents, ask the cardiac catheterization lab nurses and technicians. Unfortunately these approaches to comparing physicians’ skills are only available to hospital… Continue reading You Can’t Tell the Batters Without a Scorecard
What If My CHA2DS2-VASc Score Is One?
There is nothing simple about atrial fibrillation; it is a complicated, often overwhelming disease, both for patient and physician. One question that invariably comes up early on is the question of prophylactic anticoagulation for prevention of stroke. Who should receive anticoagulation? Which anticoagulant? How should anticoagulation be handled around the time of surgical procedures, or… Continue reading What If My CHA2DS2-VASc Score Is One?
After Life
Jonathan closed his eyes, died, and immediately woke up in a place that was, he assumed, Heaven. He could hardly contain his astonishment. A lifelong rationalist (a physicist to boot!), he was fully prepared for the eventuality that death was the end. But here he was — moments before occupied with the mechanics of dying… Continue reading After Life
Reading About Steve Jobs
I am interested in the history of computer technology and over the last couple months have read a lot about Steve Jobs. To be specific I read Walter Isaacson’s Steve Jobs, Brent Schlender’s Becoming Steve Jobs, and a book published back in 2001, Alan Deutschman’s The Second Coming of Steve Jobs. To get the point of… Continue reading Reading About Steve Jobs
Index Verborum Prohibitorum
The Catholic Church for centuries maintained a list of banned books, the Index Librorum Prohibitorum, only abolishing it in 1966. Governments, particularly fascist ones, also have had a pronounced tendency to ban books for moral, religious, or political reasons. Such censorship is a repugnant form of thought control. It is no surprise that the fascist… Continue reading Index Verborum Prohibitorum
Introducing EP Calipers
Ever since the 1990s, when computer-based electrophysiology (EP) systems were introduced, HV intervals and ventricular tachycardia cycle lengths have been measured in the EP lab by electronic calipers — simple but accurate measurements accomplished on-screen using a track ball or a mouse. Despite this, physicians still often carry a physical pair of calipers, perhaps preserved… Continue reading Introducing EP Calipers