Archive for 2012

Cost Disease

This entry is part 20 of 43 in the series Words

The Cost Disease is both the name of a book, and the economic theory espoused by this book. The theory is relatively simple at its base. There are two segments to our modern economy, the progressive and the stagnant. The progressive sector makes rapid improvement in efficiency. Examples include manufacture, particularly of items such as […]


Model T

This entry is part 23 of 43 in the series Words

An article in the New York Times points up some of the shortcomings of the push for meaningful use of electronic medical records (EMR): it’s vulnerable to fraud. The Department of Health and Human Services is shocked, just shocked, that perhaps some physicians and hospitals may have not been entirely accurate in self-reporting how well […]



This entry is part 19 of 43 in the series Words

Faced with a long dinner menu, it’s hard to decide what to order. (Even with a medium-sized menu, my wife always says “You go ahead and order, I haven’t decided yet.” But that’s extreme.) It’s not just an urban legend. There are scientific studies that demonstrate it. The study When Choice is Demotivating by Sheena […]



As of 2012, a new metric for ED throughput is physician contact time – with the caveat that assigning a physician name on a tracking system, or the time of the first orders, is not adequate to measure this. Surprised? Some docs put their name on the patient as soon as the patient arrives in […]


Speech Recognition

This entry is part 3 of 3 in the series Charting

In the Beginning: VoiceEM Back in 1988, Ray Kurzweil came out with speech-recognition software, including something called VoiceEM. It was an emergency medicine physician charting application; there was also VoiceRAD for radiology. These were DOS programs that ran with that typical DOS 80 character x 25 character text screen. In addition to having a medical-specific vocabulary, VoiceEM had […]