rwilsonMD

I want to tell you about a typical morning for most doctors. Before we see our first patient, we’ve already navigated three system logins, reconciled a medication list that populated incorrectly, clicked through 14 screens to place a routine order, and added documentation that has nothing to do with the patient’s actual problem but everything to do with satisfying a billing algorithm. And the day hasn’t even started yet. The first patients hasn’t been seen. The Electronic Health Record was supposed to transform medicine. Better data. Fewer errors. Coordinated care. The promise was real but the execution has been a disaster. The 2009 HITECH Act pushed hospitals and practices to adopt EHRs rapidly through “meaningful use” mandates. These are federal requirements that defined how EHRs had to be used to receive CMS incentive payments. The result? A small number of dominant vendors built systems designed around regulatory compliance, not clinical workflow. Physicians had no market leverage. We got what regulators spec’d out, not what medicine needed. The numbers tell the story no one wants to say out loud: - Primary care physicians spend nearly 6 hours per day interacting with the EHR - For every 1 hour of direct patient care, physicians spend nearly 2 hours on documentation - After-hours “pajama time” — charting at home after a full clinical day — has become so normalized we gave it a nickname instead of fixing it - Burnout directly linked to EHR burden now affects the majority of U.S. physicians As an orthopedic surgeon, I trained to operate, to evaluate a patient, and to make a judgment call that restores function and changes lives. Somewhere along the way, the system decided my most important job was clicking boxes. @DrDiGiorgio and colleagues put it plainly in their research on EHR burden among neurosurgery residents: the continuous addition of clicks has been gradual and multi-layered — and it is actively detracting from trainees’ educational experience. This isn’t just a senior physician problem. We are training an entire generation of physicians to be data entry clerks. The hard truth is that EHR dysfunction isn’t a technology problem. It’s a policy problem. Meaningful use mandates consolidated the market, eliminated competition, and locked medicine into systems built for compliance rather than care. The fix has to include policy and not just better software. We built this regulatory structure. We can reform it. Tomorrow: Prior authorization — the other wall between your doctor’s judgment and your care.

Outcomes by Achieved LDL-C in Prior Stroke ahajrnls.org/4pVXoCq

#ICYMI #OriginalResearch, DAPA ACT HF-TIMI 68 trial: in-hospital initiation of dapagliflozin did not significantly⬇️risk of CV death or worsening HF compared w/ place... ahajrnls.org/3LMUam7 @SubodhVermaMD @akshaydesaimd @UoGHeartFailure @modeldoc @TIMIStudyGroup @ddbergMD