The Digital Doctor: Hope, Hype, And Harm At The Dawn Of Medicine's Computer Age Download Free (EPUB, PDF)
The New York Times Science Bestseller from Robert Wachter, Modern Healthcare’s #1 Most Influential Physician-Executive in the US While modern medicine produces miracles, it also delivers care that is too often unsafe, unreliable, unsatisfying, and impossibly expensive. For the past few decades, technology has been touted as the cure for all of healthcare’s ills. But medicine stubbornly resisted computerization – until now. Over the past five years, thanks largely to billions of dollars in federal incentives, healthcare has finally gone digital. Yet once clinicians started using computers to actually deliver care, it dawned on them that something was deeply wrong. Why were doctors no longer making eye contact with their patients? How could one of America’s leading hospitals give a teenager a 39-fold overdose of a common antibiotic, despite a state-of-the-art computerized prescribing system? How could a recruiting ad for physicians tout the absence of an electronic medical record as a major selling point? Logically enough, we’ve pinned the problems on clunky software, flawed implementations, absurd regulations, and bad karma. It was all of those things, but it was also something far more complicated. And far more interesting . . . Written with a rare combination of compelling stories and hard-hitting analysis by one of the nation’s most thoughtful physicians, The Digital Doctor examines healthcare at the dawn of its computer age. It tackles the hard questions, from how technology is changing care at the bedside to whether government intervention has been useful or destructive. And it does so with clarity, insight, humor, and compassion. Ultimately, it is a hopeful story. "We need to recognize that computers in healthcare don’t simply replace my doctor’s scrawl with Helvetica 12," writes the author Dr. Robert Wachter. "Instead, they transform the work, the people who do it, and their relationships with each other and with patients. . . . Sure, we should have thought of this sooner. But it’s not too late to get it right." This riveting book offers the prescription for getting it right, making it essential reading for everyone – patient and provider alike – who cares about our healthcare system.
Hardcover: 352 pages
Publisher: McGraw-Hill Education; 1 edition (April 1, 2015)
Language: English
ISBN-10: 0071849467
ISBN-13: 978-0071849463
Product Dimensions: 6.3 x 1.2 x 9.2 inches
Shipping Weight: 1.2 pounds (View shipping rates and policies)
Average Customer Review: 4.6 out of 5 stars See all reviews (115 customer reviews)
Best Sellers Rank: #26,681 in Books (See Top 100 in Books) #5 in Books > Business & Money > Industries > Pharmaceutical & Biotechnology #5 in Books > Medical Books > Medical Informatics #6 in Books > Medical Books > Allied Health Professions > Medical Technology
When internal whining became my mental fallback position, I knew it was time for professional change. Two years after I sold my private practice to a large hospital corporation due to a lack of funds to install and maintain electronic record-keeping, I bailed out. Fortunately, I was able to semi-retire from the practice of internal medicine way before I imagined and for reasons I could not have guessed at three decades before. Dr. Wachter's book has been a welcome clarification of that which soured my enthusiasm for a job I loved and to which I was perfectly suited for 28 contented out of 30 years in total.I never thought myself as a "technophobic obstacle" nor a Dr. Luddite, In fact, I welcomed the chance to chart as I talked (and heaven help the docs who don't know how to touch type!). I forgave the fact that many exam rooms were not designed to even glimpse the patients to whom I spoke even out of the corner of my eye, some monitors wall-mounted at a height too low to stand and too high to sit. Alas, the speed with which I typed my notes did nothing to make up for the tedium of multi-stepping through many windows on the road to e-prescribing, e-ordering, and e-referring. Computer time stretched from pre-breakfast to post-dinner, and all my colleagues and co-workers were faces-to-wall and backs-to-each-other removing much of the joy of the workplace.But the worst blow to workday satisfaction came in the form of regulations, guidelines, (not so) meaningful use requirements, quality committees, productivity goals, dashboards, and coding reviews/rebukes. Big damn governmental involvement in my daily workflow. Dr.
In this book, Robert Wachter provides a comprehensive exploration of the challenges and complications of computerization across the gamut of medical care.He gives us a thorough history of the medical record (actually, the state and interpretation of the medical record (an ongoing topic throughout the narrative) and how it evolved as the medical field changed. He lets us in on medical billing practices used by insurance companies in paying doctors (an eyeopener!) he tells us what computers can and cannot do; he muses about ways that use of technology changes our behavior; he tells us about various systems (examples: Epic and Athena) in use and their costs and benefits,; he talks about the "productivity paradox" and blind trust of wrong information when it is displayed on a sophisticated and expensive machine; and he laments the fact that medical professionals are more rushed than ever (partly because of the effects of technology) and often have their attention more on the computer screen than on their patients. In the most gripping part of the book, spanning several chapters, he recounts in detail the events leading up to a hideous medical error.In preparing to write this book, Wachter interviewed 100 highly qualified experts (their credentials are listed in a table at the end of the book) and he often quotes them He writes about issues concerning interoperability, useability, learnability (didn't know that was a word!) privacy, and the general clumsiness of systems that don't quite fit the job they are supposed to perform. He often draws comparisons between the challenges for medical care and those for aviation, which have striking parallels.
Excellent, clearly written overview of the effects of computerization on the practice of medicine. Robert Wachter has seen the transition from the days of keeping patient data on note cards and radiology rounds to the present where the computer has come between the doctor and the patient, depersonalizing medicine. While technologic change was necessary in the medical field, it has come with an avalanche of data that must be sorted through, and Dr. Wachter outlines this in a clear fashion in the first part of the book, detailing the effects upon the physicians, the patients, and the doctor-patient relationship. He illustrates his points with anecdotes that show these effects to both the layperson and the medical professional. He also details many of the unanticipated effects of technology in medicine: physician and patient unhappiness, lack of " user-friendliness", increased distractions,, and error prone systems. I loaned the book to a physician friend who told me she often found herself nodding and saying, "Exactly. This is right on the money".Part two of the book is a discussion of the use of computers in medical decision making, and part three demonstrates how a system that is supposed to reduce errors can actually increase them. Again, these topics are discussed clearly and concisely with supporting anecdotes. he follows this with chapters about the "connected patient" and the business and government players involved. He finishes with his ideas of the direction in which healthcare IT is heading.The writing is straightforward and often humorous, and topics are explained such that they can be understood by people in and out of the healthcare field.
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