<i>Annals</i> for Hospitalists Inpatient Notes - Hospitalists and Digital Medicine—Overcoming the Productivity Paradox
Authors: Robert M. Wachter
Journal: Annals of Internal Medicine (2016)

Web Exclusives19 July 2016Annals for Hospitalists Inpatient Notes - Hospitalists and Digital Medicine—Overcoming the Productivity ParadoxRobert M. Wachter, MDRobert M. Wachter, MDFrom the University of California, San Francisco, San Francisco, California.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M16-1367 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Fueled by $30 billion in federal incentive payments distributed between 2010 and 2015, medicine has finally gone digital. In 2009, about 10% of U.S. hospitals had electronic health records (EHRs). Today, about 90% do (1). That's the good news.The bad news is that the promises of health care digitization—improved quality, better safety, more engaged patients, happier clinicians, lower costs, constant innovation—have largely gone unrealized. Although few of us would exhume the 3-ring binders, the fax machines, and the Post-it notes, levels of physician unhappiness have skyrocketed, and many fingers are pointed at the EHR (2). Today, physicians, including hospitalists, ...References1. Henry J, Pylypchuk Y, Searcy T, Vaishali P. Adoption of electronic health record systems among U.S. non-federal acute care hospitals: 2008-2015. ONC Data Brief 35. Accessed at http://dashboard.healthit.gov/evaluations/data-briefs/non-federal-acute-care-hospital-ehr-adoption-2008-2015.php on 15 June 2016. Google Scholar2. Friedberg MW, Chen PG, Van Busum KR, et al. Factors affecting physician professional satisfaction and their implications for patient care, health systems, and health policy. Santa Monica, CA: RAND Corporation; 2013. Google Scholar3. Wachter RM. The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine's Computer Age. New York: McGraw-Hill; 2015. Google Scholar4. Brynjolfsson E. The productivity paradox of information technology. Communications of the ACM. 1993;36:66-77. CrossrefGoogle Scholar5. Khanna RR, Wachter RM, Blum M. Reimagining electronic clinical communication in the post-pager, smartphone era. JAMA. 2016;315:21-2. [PMID: 26746450] doi:10.1001/jama.2015.17025 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From the University of California, San Francisco, San Francisco, California.Disclosures: Dr. Wachter reports that he is a member of the Lucian Leape Institute of the National Patient Safety Foundation (for which he receives no compensation); is currently chairing a advisory board to England's National Health Service reviewing its digital health strategy (no compensation); has a contract to UCSF from the Agency for Healthcare Research and Quality to edit a patient-safety Web site; receives compensation from John Wiley & Sons for writing a blog; receives royalties from Lippincott Williams & Wilkins and McGraw-Hill for writing/editing several books; received a stipend and stock/options for having previously served on the Board of Directors of IPC Healthcare (ended in 2015); receives stock options for serving on the board of Accuity Medical Management Systems; serves on the scientific advisory boards for Amino.com, PatientSafe Solutions, QPID Health, Twine, and EarlySense (for which he receives stock options); has a small royalty stake in CareWeb, a hospital communication tool developed at UCSF; and holds the Benioff endowed chair in hospital medicine from Marc and Lynne Benioff.Corresponding Author: Robert M. Wachter, MD, Room M-994, Department of Medicine, 505 Parnassus Avenue, University of California, San Francisco, CA 94143-0120; e-mail, robert.[email protected]edu. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAnnals for Hospitalists - 19 July 2016 David H. Wesorick and Vineet Chopra Introducing Annals for Hospitalists: New Knowledge, Novel Formats, and Unique Perspectives David H. Wesorick , Vineet Chopra , and Christine Laine Introducing Annals for Hospitalists: New Knowledge, Novel Formats, and Unique Perspectives David H. Wesorick , Vineet Chopra , and Christine Laine Metrics Cited byTime Management and Time Utilization for Urology Surgeons, a Step in Implementing Social Responsibility, a Theoretical and a Practical ApproachExploring mobile working in healthcare: Clinical perspectives on transitioning to a mobile first culture of workAnnals for Hospitalists: Celebrating the One-Year Anniversary of an Easier Way for Hospitalists to Access AnnalsDavid H. Wesorick, MD and Vineet Chopra, MD, MScAllocation of Internal Medicine Resident Time in a Swiss Hospital: A Time and Motion Study of Day and Evening ShiftsNathalie Wenger, MD, Marie Méan, MD, Julien Castioni, MD, Pedro Marques-Vidal, MD, PhD, Gérard Waeber, MD, and Antoine Garnier, MD, MBAElectronic Health Records: An Unfulfilled Promise and a Call to ActionSusan Hingle, MD 19 July 2016Volume 165, Issue 2Page: HO2-HO3KeywordsElectronic medical recordsHealth careHealth care qualityHospital medicineHospitalistsInformation technologyMedical servicesMotivationResearch quality assessmentSafety ePublished: 19 July 2016 Issue Published: 19 July 2016 Copyright & PermissionsCopyright © 2016 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...