Column: A Quiet Revolution in EMR Usability

Recently, Shahid Shah, CEO of Netspective Communications, argued in this journal that physicians have shied away from electronic medical records (EMRs) because they have a negative impact on productivity.¹

“It’s not about the money… money being thrown at physicians won’t solve bad [EMR] design,” said Shah, who was referring to HITECH, the federal government’s incentive plan to accelerate their adoption. “If vendors respected service and product improvement as much as chasing new sales, [they would produce] minimally time-consuming software.”¹

Column: How To Obtain Quality IT Help

Pressure, Seduction, & Treachery

Succumbing to the pressure on physicians to have a “meaningful use” (MU) strategy, you may be considering how to implement electronic health records (EHR) systems to achieve MU and receive incentive reimbursements. If you’re in the market for software, it’s likely you’re being inundated with case studies from vendors demonstrating how you, too, can attain the success their clients enjoy. Don’t be fooled; it’s highly unlikely that your experience will be the same as the doctors’ in the vendor-sponsored case study. Those select case studies are inevitably chosen to seduce you with stories of physicians who doubled their incomes allowing them luxuries such as vacationing more often. Those tales are rarely true. Unless every patient presents in the same fashion every time for every condition with every provider in your practice, adopting clinical systems into your care routine will be challenging. Rather than merely accepting the scenarios described in the case studies, it would be wise to employ outside help.

Overview The advantages of PET/CT include identification of abnormalities which can be targeted for percutaneous biopsy to determine metastatic disease. However, it is difficult for both the clinician and patient when positive PET findings do not have a correlate identified on CT. We present the first published case of successful biopsy of an isolated PET avid bone lesion without a CT correlate in a patient with newly diagnosed esophageal adenocarcinoma using a PET guided biopsy technique.

Overview Traditionally, the most definitive option for treating active gastric variceal bleeding from splenic vein obstruction is splenectomy.  Herein, we report a successful case of splenic vein stent placement to remedy sinistral portal hypertension with refractory gastric variceal bleeding resulting from splenic vein occlusion.