The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine's Computer Age / Edition 1

by Robert Wachter

Overview

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.

Product Details

ISBN-13:	9780071849463
Publisher:	McGraw Hill LLC
Publication date:	04/01/2015
Edition description:	Net
Pages:	352
Product dimensions:	6.00(w) x 9.10(h) x 1.40(d)

About the Author

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.

Table of Contents

Preface xi

Chapter 1 On Call 1

Chapter 2 Shovel Ready 9

Part 1 The Note

Chapter 3 The iPatient 23

Chapter 4 The Note 29

Chapter 5 Strangers at the Bedside 35

Chapter 6 Radiology Rounds 47

Chapter 7 Go Live 65

Chapter 8 Unanticipated Consequences 71

Part 2 Decision and Data

Chapter 9 Can Computers Replace the Physician's Brain? 93

Chapter 10 David and Goliath 105

Chapter 11 Big Data 115

Part 3 The Overdose

Chapter 12 The Error 127

Chapter 13 The System 131

Chapter 14 The Doctor 135

Chapter 15 The Pharmacist 139

Chapter 16 The Alerts 143

Chapter 17 The Robot 155

Chapter 18 The Nurse 159

Chapter 19 The Patient 165

Part 4 The Connected Patient

Chapter 20 OpenNotes 171

Chapter 21 Personal Health Records and Patient Portals 183

Chapter 22 A Community of Patients 195

Part 5 The Players and the Policies

Chapter 23 Meaningful Use 205

Chapter 24 Epic and Athena 219

Chapter 25 Silicon Valley Meets Healthcare 235

Chapter 26 The Productivity Paradox 243

Part 6 Toward a Brighter Future

Chapter 27 A Vision for Health Information Technology 257

Chapter 28 The Nontechnological Side of Making Health IT Work 267

Chapter 29 Art and Science 271

Acknowledgments 281

Notes 285

National Coordinators for Health Information Technology 309

People Interviewed 311

Bibliography 319

Illustration Credits 321

Index 323

Editorial Reviews

Janus was the Roman god of doorways and beginnings, the one depicted in sculpture with two faces on a single head. An elderly face gazes backward. (Fondly? Bitterly? Regretfully? Who knows.) A youthful face looks forward, presumably with resolution and hope. 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. The Digital Doctor is one of several books over the last few years to address the conquest of medicine by digital technology…Most previous authors have chosen sides, either mourning the old or hailing the new. Dr. Wachter is unusual for his equipoise…He is also an exceptionally good, fluent writer.

The New York Times - Abigail Zuger