Morgue Duty with National Coordinator for Health IT, Dr. Micky Tripathi 

My mother was a church secretary during the computerization of secretary jobs. I remember some older secretaries chose to retire rather than deal with computers. I was proud of my mom for learning to use a computer for her job and working until she was 85 years old, in 2012. I worked in homecare in the 1990's when homecare nursing was transitioning to electronic records. The nurses said it initially took way longer to document when using the laptop computers and software. The gains in accessing data is really really helpful. Thanks to everyone for powering through the electronic learning curve.

The conversation around 40:00 concerning patient access to results is really interesting. From the perspective of an RN, I frequently get patients wanting to immediately know test/imaging results, and they have that right. I do think the context piece is important and I tell my patients that. Like y’all explained, one thing AI can never replace in physicians is the clinical thinking process

As a developer in Norway (where we're currently introducing a new solution for our own health platform), and a new subscriber, this one hit perfectly!

As a blood banker, while Epic has its flaws, being able to access complete transfusion histories have been amazing. Patients often dont know if they got blood, what they got, or if they have antibodies. When antibodies can stealth and become undetectable, these histories are a fantastic tool for making sure I give properly matched blood.

I was amazed that my primary doctor was able to look up my bloodwork and x-rays taken at the hospital. Helped in my treatment plan.

Our local bandaid station is currently transitioning to EPIC. The big positive I see is that our doctors at Johns Hopkins will be able to pull up imaging, labs, and notes. GRMC has never been known to send reports to the physicians who ordered the tests if outside of our area. And rarely can the docs get a hold of them before or during our follow up appointments. Thankfully, JHH has MyChart, and they can send messages instead of having to travel 4 hours to finally get the results. Though our cardiologist at JHH doesn't care for the dictation of EPIC Live. He got a kick out of its translation of Ehlers Danlos Syndrome: "Hairless Dander Syndrome!" I do believe he was close to drop kicking the computer out the window!😂

54:26 I literally had someone at a doctor's office offer to fax something to me, personally, at my home, this very morning. I literally said "Well, I don't have a fax machine, because you know, it's 2023." 😂🤦‍♀️

Epic is the best EMR, hands down. It has quite a learning curve but once you’ve learned the learning curve you won’t ever want to go back to any other EMR you’ve ever used😍 I went from Epic to meditech and it felt like I literally stepped off a time machine and landed in 1998 😂

Triple clicks are great! They highlight an entire paragraph in word. It also gets you into Guided Access in an iPad (to control what your kid can do without you watching every second).

As a young internal medicine doctor from Belgium, it furiates me that patient medication lists are still not centralized and patients are not even aware of it. The GP, all hospitals, apothecary and the patient should all have the same list for any patient. Admitting a geriatric patient in the middle of the night with no proper medication list shouldn't be a thing in this age but it still is. Or when we have one list in our electronic file, that looks not at all like the list of the GP referral and then the patient pops out his own list that's still different from both others.

I’m a nursing student and the hospital I’m assigned to for clinical uses EPIC!

I wanted to be screened (blood test) for breast cancer. However the doctor told me if I come back positive it would affect my health insurance. So I didn’t get the test.

I loved my epic go live and being a super user in my organization.

I remember getting a CD when I requested my medical records a few years ago. I had to start up my old nearly dying laptop just to access the CD. I now just have a gaming PC and a tablet, so if I ever get another CD of my records, I would be screwed!

The part about lack of coverage for phones is very true. I work at Henry Ford WB and some parts of the first floor and basement cannot be reached. Hence pagers are reliable still. Quite sad. I think an easy fix would be improving wifi connectivity and allowing connection over said network for seamless communication.

This was really cool to listen to. Learned a lot and was neat to learn how fast stuff has been swapping over to more digital frontier

Loved this, keep it up!

The fax machine is HIPAA-compliant because HIPAA itself deems a fax machine to be a secure. So you have something straight-forward and which is explicitly carved out in the law, or you have something complex which might not be.

I can tell this was professionally captioned because the captions spell HIPAA correctly.

New subscriber watching from Uganda Africa an eye 👀 doctor

Technology, especially regarding communication, really should be pervasive at this point. A strong push on standardisation would help, but as described a big issue is the willingness of different actors to actually implement interoperability and such. One thing about all the AI talk as either a tool or a "replacement" for some people, is that there is a lot of confusion thanks to how AI is depicted in the media nowadays. AI will provide a lot of help to make systems accessible to a larger audience, and help turn heaps of data into an indexed, accessible source of knowledge, that's for sure. And it's not news; although there have been recent progress, we've already been using AI for that for years. The big "leap" now is that it's been pushed in the hands of the general public, and while it was inevitable, it's a bit unfortunate that it happened without the proper warnings. We are fast to attribute more capabilities to these systems than they actually have, stuff like "thinking" and "making decisions". They don't do any of that, and that's by design. It's better to see current technology as a huge statistical engine with a nicer user interface. Anything that looks like interpretation from AI is basically saying "well, these two things seems to happens together a lot, so they must be linked", and that is the limit people have to understand these systems have. AI will be incredible at extracting some obscur informations about rare situations hidden in hundreds of thousands of documents, which have obvious applications in many fields, but merging informations and produce interpretations and new things is really not the thing we should use it for.

That doctor literally just got up, left the room, and said "I quit." 😂😂🤣🤣🤣

I remember in the 1980's when the pharmacy had software, but the charts were still paper, and the lab department had a different software system which couldn't interact with the pharmacy system. The nurses had to input med and lab orders into computers.

I love living in Finland where you can click any agreement or make any contract and take it to the court even if it says "you agree to let us do this or that or you're bound to this and that", the law protects you from unreasonable and illegal contracts. Like even with a case like an employer hires you as an entrepreneur (a recent scam with food delivery companies to avoid paying all the employee costs like insurances and sick leaves and delivery transportation method like car etc) and the employment is clearly employee-employer relationship, the employer is fined and obligated to compensate adequately, terminate or change the contract. Or if a phone salesperson sells something to an alzheimer patient or similar, the subscription/deal will be nullified etc etc. The digital systems are so great for some things, but they are so bad for some other things. Like these days nurses and doctors spending a ton of time with their computers and sometimes the patients even get to be the secondary part of the process while the computer is the first priority. They'd really need Jonathans for everyone. And from the patient standpoint like was also demonstrated in this discussion, how your information is logged in every facility and such, and it's NEVER available where you go later, so they'll ask you the same basic information every time and take let's say x-rays of your teeth again and again and it's the first time for the doctor or nurse and you get nothing done for you and they have no history to help them with you. And the systems not communicating like he explained. I don't know who was behind the big idea that we first spent a ton of money with different units all contracting a digital system for their regions and then the systems don't communicate and there was even a scandal with the new system of the capital area where doctors were scared to say out loud that the system endangers patients with wrong recommendations and information and UI being impossible to use reasonably, the system not functioning properly etc etc, while the staff was saying there's no problem or very minor problems and almost blackmailing the doctors not to report problems or discuss them. And to top it off then Finland spend a ton of money to renew the healthcare system and it's somewhat shitty and expected to at best be equal or better than the old one in 10 years, while the neighbors in Estonia renewed their system for like 10 times less money and it works better (the renewal was comparable to Finland's). So it's a mess after mess with poor management and poor software contracting, even if the idea itself was great for everyone. It would be fun to see a study if the patient queues got longer or shorter due to digitalization (of this quality) and renewal of healthcare, because I feel like the healthcare personnel have less time to take care of the patients on their work time due to the digitalization that requires them working with subpar computer systems. But hey, at least I don't think I've seen fax machines here soon to be decades. Like not just healthcare, anywhere.

ROFLMAO the fax machiene question was absolutely brilliant and I headdesked ovre that very issue all hte way over here in Germany, cause yes, yes, when will htat nonsense end?! :'D

Medical records sent results via email after Dr signed off.

Yes, patients need all ALL medical records, and I'm looking at your psychiatry. Too many bad take subjective notes get passed on to other doctors, skewing how the patient is approached in any ANY kind of future medical treatment. Transparency might help in this area, just sayin'.

the hospital i work for in the lab in kansas went from cerner to epic after we got bought by another company. epic epically sucks!!!! - jillian

Fax machine is for downtime.

iPhones are the new pagers

It’s somewhat cold hearted to mock the many fine, capable and dedicated aging physicians who were not offered the proper tools to transition to EMR

So Epic is not epic.

KILL THE FAX! Bane of my existence. I've started requesting records by postal mail because it's more reliable than the fax machines I have to work with.

Do we allow the AI to determine if care futile? It might be right but who is telling the spouse “The computer decided treating the stroke is pointless so we have withdrawn care”…

My friend had a surgery that was performed solely by a computer. That would make me uncomfortable.

I honestly wish we were back to paper records. I can't think of a single time the EMRs have helped me as a patient and I can think of more than one time it people gainsayed my expertise in my own history/body "the computer is always right". Not to mention all the data breaches. Not once in my decades with paper records did the doc have to say "A thief came in and stole all our patient records, including SSNs", but I've gotten that kind of email multiple times now thanks to EMRs.