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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.
Complete coverage of the core principles of patient safety Understanding Patient Safety, 2e is the essential text for anyone wishing to learn the key clinical, organizational, and systems issues in patient safety.The book is filled with valuable cases and analyses, as well as up-to-date tables, graphics, references, and tools -- all designed to introduce the patient safety field to medical trainees, and be the go-to book for experienced clinicians and non-clinicians alike. Features NEW chapter on the critically important role of checklists in medical practice NEW case examples throughout Expanded coverage of the role of computers in patient safety and outcomes Expanded coverage of new patient initiatives from the Joint Commission
Medical mistakes are more pervasive than we think. How can we improve outcomes? An acclaimed MD’s rich stories and research explore patient safety. Patients enter the medical system with faith that they will receive the best care possible, so when things go wrong, it’s a profound and painful breach. Medical science has made enormous strides in decreasing mortality and suffering, but there’s no doubt that treatment can also cause harm, a significant portion of which is preventable. In When We Do Harm, practicing physician and acclaimed author Danielle Ofri places the issues of medical error and patient safety front and center in our national healthcare conversation. Drawing on current research, professional experience, and extensive interviews with nurses, physicians, administrators, researchers, patients, and families, Dr. Ofri explores the diagnostic, systemic, and cognitive causes of medical error. She advocates for strategic use of concrete safety interventions such as checklists and improvements to the electronic medical record, but focuses on the full-scale cultural and cognitive shifts required to make a meaningful dent in medical error. Woven throughout the book are the powerfully human stories that Dr. Ofri is renowned for. The errors she dissects range from the hardly noticeable missteps to the harrowing medical cataclysms. While our healthcare system is—and always will be—imperfect, Dr. Ofri argues that it is possible to minimize preventable harms, and that this should be the galvanizing issue of current medical discourse.
Book Overview1. Entrepreneurs and Startups2. Doctors, Nurses, and Health Professionals3. Pharma, Biotech, Device Companies4. Patients and Consumers5. Employers, Insurers, Regulators6. Gadgets, Apps, Technology7. Behavior, Design, and Translation8. Big Data, Measurement, and Metrics9. VCs and Other Investors10. Innovation---Health matters.“When you have your health, you have everything,” wrote memoirist Augusten Burroughs. “When you do not have your health, nothing else matters at all.”Health can also be very expensive, and reducing costs isn't easy, since as Stanford health policy expert Victor Fuchs famously observed, “Every dollar of waste is income to some individual or organization.”One key challenge healthcare faces today is figuring out how to maintain health and deliver better care for patients while somehow keeping in check the overall costs associated with these activities.The good news is that there is now the massive potential for healthcare transformation. Data-driven analysis has called into question many traditional healthcare assumptions, and permits us to view the challenges in a fresh light. For instance, there seems to be little correlation between healthcare cost and quality—and great care can be delivered at lower cost if we can improve the alignment of incentives among patients, payers, and providers.Key drivers of healthcare change are the intense economic pressure of healthcare costs, the impact—to be determined—associated with the implementation of the Affordable Care Act, and the advent of inexpensive and widely accessible technologies; together these have created a platform for industry transformation the likes of which has not been seen since the dawn of modern surgery.And it's about time. Technology has been used to optimize and redefine virtually every key industry except healthcare. Manufacturing has gone from human assembly lines to robotics; banking has gone from tellers to home banking; travel has gone from agents with brochures to Travelocity; and yet the practice of medicine, in many ways, hasn't changed in decades.Many of today's most passionate entrepreneurs are trying to bring the dazzle and real promise of technology innovation to the challenges of healthcare, resulting in an explosion of companies focused on everything from wearable sensors and weight-loss apps to big data analytics and GPS-tagged hospital equipment—the “internet of things.”These emerging tools and promising technologies—which collectively comprise “digital health”—offer a promising path forward, and entrepreneurs and innovators are forging forward seeking to make a real difference in a field which we all need but which is sorely in need of its own tender loving care if it is to flourish in tomorrow's world.As Hippocrates once said, “Healing is a matter of time, but it is sometimes also a matter of opportunity.” And technology—if judiciously applied—may be just the tonic to help reinvigorate the health of our healthcare industry.The key challenge faced by would-be disruptive technologists is not only recognizing potentially useful analogs from other industries, but also understanding the ways in which health remains fundamentally different.Amid the clamor to disrupt healthcare, we should also take care to preserve and augment what may be right about medicine—the doctor/patient relationship for example, or the drive of inquisitive physicians, especially within academic centers, to continuously push and challenge the limits of what is known and what is possible.In Tech Tonics—a distillation of our writing and thinking over the last several years—we introduce the reader to the fascinating digital health space, including a ground-level view of the landscape, the structural challenges, the players, and the progress.
Imagine an epidemic that kills over one hundred Americans every day. Now stop imagining. Each year doctors and nurses kill nearly one hundred thousand Americans. By mistake. They operate on the wrong patients, prescribe the wrong drugs, and leave instruments inside body cavities after surgery. Meanwhile, hospitals spend billions on new gadgets, marble lobbies, and slick billboards even as safety continues to be ignored. Until now. Internal Bleeding exposes the dark secrets behind the glistening facade of modern medicine. Doctors Robert Wachter and Kaveh Shojania, professors at one of America's leading medical schools and two of the world's foremost authorities on medical mistakes, shatter the silence to tell the dramatic and compelling stories of real patients betrayed by a system they trusted to save them. Through these stories, the authors reveal the inner workings, gut-wrenching dilemmas, and heartbreaking tragedies of our overburdened, understaffed health care system. Internal Bleeding provides an insider's view of how professional caregivers think, feel, and operate-facts that every patient and family must know to avoid becoming just another "mistake." In the groundbreaking tradition of Fast Food Nation , Internal Bleeding paints a vivid and unforgettable picture of a system gone terribly wrong, and what doctors, nurses, hospital CEOs, and policy makers must do to make it right.
The COVID-19 pandemic has exacerbated burnout for clinicians and administrators alike, heightening the need for this practical guide that provides a comprehensive approach to empowering physicians while ensuring organizational resilience. In this second edition of Preventing Physician Burnout: Curing the Chaos and Returning Joy to the Practice of Medicine, doctors Paul DeChant and Diane Shannon define burnout, explore the consequences for physicians, patients, and the health care system, identify the underlying causes that are fueling the burnout epidemic, and provide case studies with specific interventions that have demonstrated success in healing the broken clinical workplace.Based on their experience and extensive interviews with experts in burnout, health care, and Lean management, they give voice to patient advocates, burnout researchers, leaders of health care organizations, and the physicians themselves. DeChant and Shannon also share examples of strategies that hospitals and physician practices across the United States are using to address the root causes of burnout among physicians, including action items for preventing burnout and curbing the crisis."It is hard to see how we can create the health care system we want and need on the backs of joyless and unengaged doctors. This well-written, practical book offers the prescription we need to address this crisis." Robert Wachter, MD, author of The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine's Computer Age
The essential guide by one of America's leading doctors to how digital technology enables all of us to take charge of our health A trip to the doctor is almost a guarantee of misery. You'll make an appointment months in advance. You'll probably wait for several hours until you hear "the doctor will see you now"-but only for fifteen minutes! Then you'll wait even longer for lab tests, the results of which you'll likely never see, unless they indicate further (and more invasive) tests, most of which will probably prove unnecessary (much like physicals themselves). And your bill will be astronomical. In The Patient Will See You Now, Eric Topol, one of the nation's top physicians, shows why medicine does not have to be that way. Instead, you could use your smartphone to get rapid test results from one drop of blood, monitor your vital signs both day and night, and use an artificially intelligent algorithm to receive a diagnosis without having to see a doctor, all at a small fraction of the cost imposed by our modern healthcare system. The change is powered by what Topol calls medicine's "Gutenberg moment." Much as the printing press took learning out of the hands of a priestly class, the mobile internet is doing the same for medicine, giving us unprecedented control over our healthcare. With smartphones in hand, we are no longer beholden to an impersonal and paternalistic system in which "doctor knows best." Medicine has been digitized, Topol argues; now it will be democratized. Computers will replace physicians for many diagnostic tasks, citizen science will give rise to citizen medicine, and enormous data sets will give us new means to attack conditions that have long been incurable. Massive, open, online medicine, where diagnostics are done by Facebook-like comparisons of medical profiles, will enable real-time, real-world research on massive populations. There's no doubt the path forward will be complicated: the medical establishment will resist these changes, and digitized medicine inevitably raises serious issues surrounding privacy. Nevertheless, the result-better, cheaper, and more human health care-will be worth it. Provocative and engrossing, The Patient Will See You Now is essential reading for anyone who thinks they deserve better health care. That is, for all of us.
BESTSELLING GUIDE, UPDATED WITH A NEW INFORMATION FOR TODAY'S HEALTH CARE ENVIRONMENT Health Care Information Systems is the newest version of the acclaimed text that offers the fundamental knowledge and tools needed to manage information and information resources effectively within a wide variety of health care organizations. It reviews the major environmental forces that shape the national health information landscape and offers guidance on the implementation, evaluation, and management of health care information systems. It also reviews relevant laws, regulations, and standards and explores the most pressing issues pertinent to senior level managers. It covers: Proven strategies for successfully acquiring and implementing health information systems. Efficient methods for assessing the value of a system. Changes in payment reform initiatives. New information on the role of information systems in managing in population health. A wealth of updated case studies of organizations experiencing management-related system challenges.
This is a text for nursing and medical practitioners who are learning how to diagnose and treat mental disorders with medication. Skills-based, it focuses on key issues such as how to start and stop medication, how to dose and when to change medication.
From the nation’s leading experts in healthcare safety—the first comprehensive guide to delivering care that ensures the safety of patients and staff alike.One of the primary tenets among healthcare professionals is, “First, do no harm.” Achieving this goal means ensuring the safety of both patient and caregiver. Every year in the United States alone, an estimated 4.8 million hospital patients suffer serious harm that is preventable. To address this industry-wide problem—and provide evidence-based solutions—a team of award-winning safety specialists from Press Ganey/Healthcare Performance Improvement have applied their decades of experience and research to the subject of patient and workforce safety. Their mission is to achieve zero harm in the healthcare industry, a lofty goal that some hospitals have already accomplished—which you can, too.Combining the latest advances in safety science, data technology, and high reliability solutions, this step-by-step guide shows you how to implement 6 simple principles in your workplace. 1. Commit to the goal of zero harm.2. Become more patient-centric.3. Recognize the interdependency of safety, quality, and patient-centricity.4. Adopt good data and analytics.5. Transform culture and leadership.6. Focus on accountability and execution.In Zero Harm, the world’s leading safety experts share practical, day-to-day solutions that combine the latest tools and technologies in healthcare today with the best safety practices from high-risk, yet high-reliability industries, such as aviation, nuclear power, and the United States military. Using these field-tested methods, you can develop new leadership initiatives, educate workers on the universal skills that can save lives, organize and train safety action teams, implement reliability management systems, and create long-term, transformational change. You’ll read case studies and success stories from your industry colleagues—and discover the most effective ways to utilize patient data, information sharing, and other up-to-the-minute technologies. It’s a complete workplace-ready program that’s proven to reduce preventable errors and produce measurable results—by putting the patient, and safety, first.