Internal Medicine Physician / Healthcare Systems Design / Electronic Health Records / Weight / Lipids
Ottawa, Canada
Joined May 2012
- Tweets889
- Following4.1K
- Followers1.4K
- Likes10.6K
Gregory Schmidt retweeted
Unpopular opinion: the hardest part of cancer isn't the cancer. It's the unpaid admin job the healthcare system hands you.
Here's all the shit I did across 27 months so far:
64 "please fill out your history" questionnaires
80 calls just to get pills delivered
150+ appointments and calls
79 days in a waiting room
23 CT, MRI and PET scans
209 scheduling messages
5 radiation treatments
34 full blood panels
5,500+ cancer pills
1,360 lab results
1 thoracentesis
2 biopsies
The phone trees, the endless redundant forms, the reschedules and the "we never received that order" are what grind you down.
And I'm someone who's good at this stuff. Imagine doing it sick, alone, or without the time.
If someone you love is in treatment, "let me know if you need anything" is nice. "I'll make the pharmacy call this week" is better.
Prior auth & appeals are non value added waste & should be AI automated.
But EHR time should not automatically be categorized as non-patient-care work
Synthesizing clinical data from EHR is fundamental to patient care. But EHR needs to be optimized to efficiently organize & present data to physician for reasoning that will maximize correct clinical mgmt in shortest time needed for review
Documentation time needs to be collapsed. With focus on physician’s assessment and decision-making, while automating record keeping of the raw background encounter data
I had a very romantic idea of what oncologists actually do all day.
Ever since my Dad got cancer, I’ve been fascinated by oncology. He's fortunate to have a great onco
Soon after, I read Emperor of All Maladies & this image became almost mythical
Over the past year, I started spending a LOT of time shadowing oncos at community clinics & NCI giants.
Stuff I witness horrifies me.
My fantasy is now maybe ~30% true
Oncos are forced engage with entities that have perfected the art of treating them like sh*t.
Numbers are brutal:
▪️96% say prior auth delays treatment
▪️80% say it has caused disease progression
ACCC recently gave this a name: administrative toxicity
Welcome to modern day cancer care..
Put brilliant minds through 15 years of training.
Then surround them with mind-numbing work
- - - - -
Plot Source: @Jori_health
- - - - -
Great visualizations of intervention calling overdue patients
We just published a blog post about creating dashboards for managing overdue patients. Exposing data drives powerful feedback loops for healthcare workers and health systems managers. By @jamiecarter7. simple.org/blog/revealing-da…
Gregory Schmidt retweeted
I teach this in the first lecture of my Cell Biology and General Physiology course @USCDornsife.
Gregory Schmidt retweeted
Medicine #FooledbyRandomness DuJour:
The heuristic 220 minus age for max heart rate is UNUSABLE. One of those stochastic measures deemed deterministic. It explains <20% of the variations!
See my video on misusing the law of large numbers going from the general to the particular.
Gregory Schmidt retweeted
Dr Ashish Krishna has published an article in a CDC journal that shows Simple.org saves nurses ~24 minutes each day, compared to hospitals that use paper records. That's HUGE for overworked nurses who can focus more on patient care. ⏲️👏cdc.gov/pcd/issues/2023/22_0…
Gregory Schmidt retweeted
‘Why FND is not Feigning or Malingering’ - our new @NatRevNeurol review and synthesis - with @M_Yogarajah and Mark Edwards nature.com/articles/s41582-0…. a thread… 1/
Gregory Schmidt retweeted
Jet injectors were used for mass vaccination, and as an alternative to needle syringes. The devices used compressed air to deliver vaccines, forcing the liquid through the skin without a needle; the jet injector was widely hailed as "the peace gun."
Gregory Schmidt retweeted
I had #OpenAI's ChatGPT take a USMLE 119 question exam. It scored 70%
I removed questions that depend on an image. Questions have 4-6 choices.
Gregory Schmidt retweeted
Canadian doctors are being professionally advised to falsify the cause of all euthanasia deaths. When the Nazis falsified their death register, a prisoner secretly put a dot next to the birthplace for each one who was killed by lethal injection. lawliberty.org/canadas-orwel… #cdnpoli
Gregory Schmidt retweeted
Serum albumin is considered by many to be a surrogate for an individual’s nutrition status. As shown in an SR (Am J Med. 2015;128:1023), serum albumin levels are "USELESS AS MARKERS OF NUTRITIONAL STATUS"
Low albumin = inflammation, liver disease or protein losing 'opathies'
Gregory Schmidt retweeted
1/2
When you test for iron markers, do you order a fasting blood sample?
I don't, but I admit I sometimes question myself.
1. Serum iron and therefore TSAT (=Fe/TIBC) show diurnal variation and their levels increase after a meal.
2. These changes are small (<10-20%).
Gregory Schmidt retweeted
Wow, our work on Simple was just featured at Nature.com, in a great article about the India Hypertension Control Initiative. Incredible work from @kprabhdeep @drganeshkumarp @who and a host of other hard working epidemiologists. nature.com/articles/s41371-0…
Gregory Schmidt retweeted
Want to learn about designing simple tools in healthcare? @mahima_chandak and did a 20 min talk at the Figma Config conference that's now available for free. @figma
#Config2022 youtube.com/watch?v=08MWiaAM…
Gregory Schmidt retweeted
A former nurse at Scripps Memorial Hospital showed columnist @Davidlaz screenshots of the facility’s electronic health record system.
The screenshots show price hikes ranging from 575% to 675% being automatically generated by the hospital’s software. latimes.com/business/story/2…
Product tours / training of new users:
- 1 min video on first login?
- Tooltips throughout?
- Neither?
- Both?
- Other?
Do people watch/interact with these product tour approaches differently in user testing than in real life? @dburka @mmargolis
I have an easier solution: come to land of the "secure" fax machine @healthbjk
In Canada, the EHR generates a prescription to FAX to pharmacy. Pharmacy can print it. When there is problem, they fax it back to MD. MD scribbles on it. Faxes back. + scan at each step into the EHR
Summary of key articles showing why patients should be able to access to their complete medical notes, labs, reports, etc
New to #opennotes?
We rounded up 12 publications that may help health care professionals gain a deeper understanding of this new practice… and its effects.
All citations linked here 👇 and #medthread 🧵 below.
opennotes.org/news/twelve-wi…
ALT A graphic that says: 12 Essential Publications on Open Notes: Research, Best-Practices and the Future
600 Healthcare icons
open-souce & well designed
healthicons.org
You can still request additional icons and volunteer to expand the library.
This quoted post is unavailable.