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The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine's Computer Age

Bücher Herunterladen The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine's Computer Age

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"Janus is the god of medicine these days, and it is the great strength of Dr. Robert Wachter's eloquent new book that it has captured every one of these conflicting emotions, all powerfully felt and intelligently analyzed. . . . Most previous authors have chosen sides, either mourning the old or hailing the new. Dr. Wachter is unusual for his equipoise. He is old enough to remember the way things used to work (or fail to work), young enough to be reasonably technology friendly . . . He is also an exceptionally good, fluent writer."The New York Times"While he refuses to play 'Dr. Luddite,' Wachter warns that healthcare is going through a difficult, disruptive transition in which positive outcomes are possible but not guaranteed . . . . Whatever the capabilities of the enabling technology, humans will still be challenged with working with it effectively to serve human needs. In the meantime, there is plenty of room to improve the technology itself to make sure it is helping more than hurting."Forbes"As I read The Digital Doctor: Hope, Hype, and Harm at the Dawn of MedicineÂ’s Computer Age, I found myself feeling nostalgic for medicine before the digital age, even though its challenges sometimes drove me crazy. Is computerized medicine really an improvement on the past? Or are we at risk of losing the vital bond of the doctor-patient relationship? Fortunately, the author, a practicing internist, has considered these questions carefully. The Digital Doctor makes the case that, despite some serious shortcomings, computerized medicine is here to stay and, in the long run, will improve our health."                                                       The Wall Street Journal“TechnologyÂ’s multifaceted effect on medicine is illustrated by patients' new empowerment to become active participants in their own health care and the potential dangers that arise when computers micromanage clinical decision-making. Wachter weaves in interviews, portraits, and anecdotes throughout, making this an engaging book that will appeal to both general and specialist audiences. Recommended. All readers.” Choice“The Digital Doctor is not a Pollyanna-ish hyperbole about the promise of the digitalization of medicine, ‘romanticizing how wonderful things were when your doctor was Marcus Welby,Â’ or a dire prediction about how computerization will eliminate the need for a doctor altogether. It is quite simply an excellent book written with intelligence and balance for both the general public and health care practitioners.” The New York Journal of Books                                                    "Robert Wachter, voted the most influential physician [in the U.S.] by Modern Healthcare magazine, sums the optimism and frustration with the electronic health record (EHR) in The Digital Doctor—which stands to be a classic. . . . The reformers may have asked too much, too soon of electronic health records, which may deliver too little, too late. Time will tell, of course, and in twenty years either the tinkerer or the central planner will have the satisfaction of 'I told you so.' But both will applaud WachterÂ’s tome."The Healthcare Blog"The Digital Doctor is the eye-opening, well-told, and frustrating story of how computerization is pulling medicine apart with only a vague promise of putting it back together again. I kept muttering, ‘Exactly!Â’ while reading it, and that is a measure of WachterÂ’s accomplishment in telling the tale. This is the real story of what itÂ’s like to practice medicine in the midst of a painful, historic, and often dangerous transition."Atul Gawande, author of Being Mortal and The Checklist Manifesto"As scientific breakthroughs and information technology transform the practice of medicine, there is a crying need for explication, for an eyewitness who can go from the trenches to the observation booth. Wachter is one of the few people with the insight, credibility, and investigative skills to do just this. The Digital Doctor is first of all a personal journey, as Wachter travels the country, meets with key players who are shaping our future, and wrestles with their views. His intimate narrative left me entertained, amazed, alarmed at times, but always engrossed as I came to a new understanding of my own profession as it is reshaped by technology. Simply brilliant."Abraham Verghese MD, MACP, FRCP(Edin), author of Cutting for Stone, and Linda R. Meier and Joan F. Lane Provostial Professor and Vice Chair for the Theory and Practice of Medicine, Stanford University School of Medicine"A much-needed study of the moment in technological change we donÂ’t want to see: the in-between moment where technology is making things worse because we just assumed that 'adding it' would make things better. Wachter maintains his enthusiasm for the long view, but helps the reader see that getting there requires understanding of medicine and technology and, most of all, people and their needs. It needs thinking and caring; the hope for a magic bullet got in our way. Wachter deserves our gratitude for his clarity of vision and our support so that his views can become influential in policy circles."Sherry Turkle, Professor, MIT, and author of Alone Together"One of the best books I've ever read. WachterÂ’s warm humor and deep insights kept me turning the pages without interruption. To make our healthcare system work, we need new models of care and new ways of managing our technology. The Digital Doctor brings us much closer to making this happen, which is why I finished the book far more optimistic than I was when I began it. It is a must-read for everyone—patients, clinicians, technology designers, and policymakers."Maureen Bisognano, President and CEO, Institute for Healthcare Improvement (IHI)"I've long admired Bob Wachter for his skill and acumen as a physician and as a leader in the field of patient safety and healthcare quality, but this book has made me appreciate him in a new light. In The Digital Doctor, Wachter is our indispensable guide through the computerization of medicine--the rich history, forces that impede progress, and the potential for today's technology innovations to transform every aspect of healthcare. Read this book and you will see the future of medicine."Marc Benioff, Chairman and CEO, Salesforce"Bob Wachter takes the reader on a fascinating journey of discovery through medicineÂ’s nascent digital world. He shows us that itÂ’s not just the technology but how we manage it that will determine whether the computerization of medicine will be for good or for ill. And he reminds us that the promise of technology in healthcare will only be realized if it augments, but does not replace, the human touch."Captain Chesley "Sully" Sullenberger, speaker, consultant, pilot of US Airways 1549 "Miracle on the Hudson," and author of Highest Duty and Making a Difference"With vivid stories and sharp analysis, Wachter exposes the good, the bad, and the ugly of electronic health records and all things electronic in the complex settings of hospitals, physician offices, and pharmacies. Everyone will learn from WachterÂ’s intelligent assessment, and become a believer that despite todayÂ’s glitches and frustrations the future computer age will make medicine much better for us all."Ezekiel J. Emanuel, M.D., Ph.D., Vice Provost for Global Initiatives and Chair, Departments of Medical Ethics and Health Policy, University of Pennsylvania"In Bob Wachter, I recognize a fellow mindful optimist: someone who understands the immense power of digital technologies, yet also realizes just how hard it is to incorporate them into complicated, high-stakes environments full of people who don't like being told what to do by a computer. Read this important book to see what changes are ahead in healthcare, and why they're so necessary."Andrew McAfee, cofounder of the MIT Initiative on the Digital Economy, and coauthor of The Second Machine Age"An engaging, accessible, and terribly important book by one of our finest medical writers. The electronic health record is not only the most disruptive innovation in the history of healthcare, it will also prove to be transformative. In his inimitable mix of conversation, reporting, and insightful analysis, Bob Wachter explains to you why. A must-read for healthcare professionals and the public alike."Lucian Leape, MD, Professor, Harvard School of Public Health and Chair, Lucian Leape Institute of the National Patient Safety Foundation"This is the book that truly defines today's epoch of technological transformation in healthcare. Wachter tells a gripping tale about the personalities and politics behind healthcareÂ’s digital revolution. With a sweeping view that takes us from the grand political battles in Washington to the subtle changes in the interactions between people when a computer enters the picture, Wachter offers surprising, often shocking insights into how technology changes the daily lives of clinicians and patients--sometimes for the better, sometimes for the worse."Leah Binder, MA, MGA, President and CEO, The Leapfrog Group"In this brilliant and compelling book, Wachter provides us a view from the balcony of the last decade of healthcare information technology. As one of the players, IÂ’m amazed by the way heÂ’s captured the characters, the plot subtleties, and the triumphs and tragedies of the work weÂ’ve done. The book is the definitive chronicle of our modern efforts to wire our healthcare system."John Halamka, MD, Chief Information Officer, Beth Israel Deaconess Medical Center, and Professor of Emergency Medicine, Harvard Medical School"Wachter not only has unmatched insider knowledge of healthcare but he deeply understands technology as well. This breadth allows him to prescribe common sense solutions to the problems emerging from the inevitable marriage between the fields, which he reveals as a more troubled union than many suspect. The Digital Doctor not only enlightens and awakens, but it is a delight to read — rare for such an important book."Steven Levy, author of Hackers and In the Plex"A fascinating and insightful look at the digital transformation of healthcare. Thoroughly researched and brought to life by dozens of stories and interviews with practicing clinicians, Wachter plots a realistic roadmap to navigate the obstacles ahead, without the hype that frequently accompanies digital health solutions. ItÂ’s an essential read for anyone involved in our health care system: from everyday providers in exam rooms to politicians and policy makers who shape our health care system."Kevin Pho, MD, founder and editor, KevinMD.com,/p> "In a style that combines the best of storytelling, historical inquiry, and investigative reporting, Wachter takes us on the journey of how healthcare information technology is transforming healthcare, highlighting the risks along the way as well as the powerful future state we might achieve."Tejal Gandhi, MD, MPH, CPPS, President and CEO, National Patient Safety Foundation"This is a brilliant book: funny, informative, well written, and accessible. Wachter takes a very complicated subject and makes it understandable, giving new perspectives and insights whether you are yourself an EHR user or you are a patient who has watched your doctor struggle to use one. Given how rapidly EHRs have moved into health care, all of us need to understand how technology changes medicine, and, even more importantly, how it doesn't."Richard Baron, MD President and CEO, American Board of Internal Medicine

Über den Autor und weitere Mitwirkende

Robert Wachter is Professor and Chair of the Department of Medicine at the University of California, San Francisco. Author of 250 articles, he coined the term “hospitalist” in 1996 and is generally considered the “father” of the hospitalist field, the fastest growing specialty in the history of modern medicine. He is past president of the Society of Hospital Medicine, past chair of the American Board of Internal Medicine, and a recipient of the Eisenberg Award, the nation’s top honor in patient safety. For every year beginning 2008, Modern Healthcare magazine has named him one of the 50 most influential physician-executives in the U.S.; he was #1 on the list in 2015. He has been profiled in the New York Times and contributes regularly to the Wall Street Journal. The Digital Doctor is his sixth book.

Produktinformation

Taschenbuch: 352 Seiten

Verlag: MCGRAW HILL BOOK CO; Auflage: Reprint (16. April 2017)

Sprache: Englisch

ISBN-10: 1260019608

ISBN-13: 978-1260019605

Größe und/oder Gewicht:

15,2 x 1,8 x 22,9 cm

Durchschnittliche Kundenbewertung:

Schreiben Sie die erste Bewertung

Amazon Bestseller-Rang:

Nr. 90.349 in Fremdsprachige Bücher (Siehe Top 100 in Fremdsprachige Bücher)

This is the best book I have read on health informatics. It is well written and entertaining to read with numerous real life examples and knowledge gained from speaking to many shareholders in this transformation of medicine. As a clinician with a Health Informatics degree, I found the author to be on target about the past, current and future directions of the interaction of medicine and technology.

As a nurse who started out in the pen and paper days of medical records and ended up working a dozen years in clinical informatics, I highly recommend The Digital Doctor for a very readable, realistic look at the positives and negatives of Electronic Health Records (EHRs). It is by far the best feedback I've encountered from a physician's perspective (am believe me plenty of physicians have offered feedback). I especially appreciate that his scope isn't limited to the physician's bubble - he is well-informed about the major impacts to nurses, pharmacists, patients and other health care players. While I know few clinicians who would want to go back to the pen and paper days, even fewer would argue that EHR’s have fully lived up to their potential. Dr. Wachter discusses his own experiences and interviews many of the top players in the field to explain why implementing an EHR is a lot more complicated than on-line banking, and other electronic systems He relates a harrowing example of a Septra overdose (38 1/2 pills), given despite a gauntlet of electronic alerts, that shows EHRs can create new types of errors. Finally, he recommends improvements and envisions where EHR’s may be headed in the future.

Concisely tells the story of the transformation of medical care from hand written notes to voice recognition software.Covers the complexities of today's EMR which is not just a document organizer, but the backbone of modern health care systems including all aspects of patient care, patient safety, inventory control, and billing.Also discusses how these changes are affecting both patient and provider satisfaction.As a recently retire (after 36 years in practice) surgeon who went from paper records to an Epic Superuser this book rings particularly true. I enjoyed it immensely.

I'm a retired (disabled) 64 yo internist living in St Louis. I loved everything about medical practice except for the GDC (gosh darned computer). I lived through the nightmare of transitioning from paper to electronics. Hard and expensive enough by itself. Felt it intruded in the patient physician relationship. Shortly thereafter, Meaningful Abuse standards came into existence. Even more onerus. I can't say electronics are all bad The book is slightly dated, but the history is accurate and many issues mentioned in the book still exist.I was an owner/employee of an 80 doc group in St Louis. We needed a new EHR. We checked out vendors. The 2000# gorilla, Epic, woud not demo their product because we were "too small" (although we would have liked to use the same EHR as the local hospitals). We chose NextGen. Problem 1. Getting it up and running. Our group has to date asked for over 14,000 recommendations to the code writers to try to improve work flow. Problem 2 Our EHR couldn't talk to the hospitals' Epic systems. Problem 200. As pointed out in the book by a practioner trying to meet Meaningful Abuse standards, I also had a large library of patient handouts on numerous disease states. When confronted by computer stupidness requiring me to print out "their" version (often useless), I would do so to meet meaingful use standards. I would then trash the printed copy and give them my own version.Current issues for primary care docs. Information unavailability. Reports scanned into the chart often end up in places in which I would have never looked. Inability to seamlessly transfer my medical notes to anyone outside of my EHR system. (Interestingly, Barnes Hospital here uses a different version of NextGen, and our computers can't talk to one another). Docs "ignoring" their patients in the exam rooms while trying to click check boxes on the GDC (in retrospect, I should have employed a scribe, despite the perceived presence of a total stranger in the exam room.) I lament the loss of patient/doc "direct" contact (I was guilty of that, too). Spending most of one's time trying to please the computer's and government's masters DEFINITELY impaired my doc/patient relationship. I truly believe that actually getting the patient undressed and "laying on hands" (i.e. actually doing a clinical exam) is both helpful figuring things out medically, and emotionally helping patients trust us docs. And finally for now, I agree having access to the latest in computerized knowledge (I used UpToDate) helped me provide optimal healthcare to my patients.

I am a practicing physician and medical software developer who has lived through the era described so eloquently in this excellent book! By far the best book that I've read about the transition from paper charts to digital medical records. Dr. Wachter writes with great wisdom and perspective about an extremely complicated but important aspect of moving our healthcare system from a fee-for-service environment to a quality-based system based on patient safety, outcomes and satisfaction. A must read for any physician or provider who wrestles with thoughtfully providing excellent medical care in the ever changing American healthcare system. Dr. Wachter is a gifted writer and thinker whose work has, and will, influence many thought leaders in our healthcare system. Read this book! And, I almost never say that.....

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