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Atul_Gawande's profile
Atul Gawande
Atul Gawande
Atul Gawande
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@Atul_Gawande

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Atul GawandeVerified account

@Atul_Gawande

Surgeon, Writer, Researcher, Dilettante. https://www.ariadnelabs.org/  http://www.lifebox.org/ 

atulgawande.com
Joined January 2011

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    Atul Gawande‏Verified account @Atul_Gawande Jul 27

    Important study: Hospitals have a digital learning curve. Deaths go UP 0.11% during adoption of a new EMR function, but wind up going DOWN 0.21% per year for each key function. I still hate my computer. But this is a striking effect.https://reut.rs/2LFxe7O 

    6:14 AM - 27 Jul 2018
    • 339 Retweets
    • 556 Likes
    • Micki & Charles Open Door Media scott baker Sylvia Nan Cheng, MDes shawn dowling Lennox Huang Virginia Carlson Kevin #RestoreTheVRA Sæverud 🇳🇴🚴🏼🇵🇷 EdifyLDN
    31 replies 339 retweets 556 likes
      1. Atul Gawande‏Verified account @Atul_Gawande Jul 27

        Here are the details of the study showing that electronic medical records do save lives. Brilliantly done by #SunnyLin @ashishkjha @j_r_a_m https://www.healthaffairs.org/doi/10.1377/hlthaff.2017.1658 …

        8 replies 131 retweets 231 likes
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      2. R. Lamartiniere, MD‏ @rlamartini Jul 27
        Replying to @Atul_Gawande

        Still not a fan of nurses spending as much or more time on computers than face to face time with patients. Same problems with doctors. Statistics don’t tell the whole story!

        2 replies 2 retweets 12 likes
      3. Victoria Kulli‏ @vkulli Jul 27
        Replying to @rlamartini @Atul_Gawande

        I am a nurse, and when I worked at the bedside, I spent over half my time on the computer. Granted, I worked in admissions, but we still did assessments and discharging of patients.

        0 replies 0 retweets 4 likes
      4. End of conversation
      1. New conversation
      2. David Cook‏ @DrDavidCook1971 Jul 28
        Replying to @Atul_Gawande @ShaunLintern

        Electronic records generally are a plus, coming from someone who worked in the days when you had zero information about a new admission until someone found the old notes, lots of mistakes occurred just generally put down to ‘unavoidable’as no old records available

        1 reply 1 retweet 3 likes
      3. David Cook‏ @DrDavidCook1971 Jul 28
        Replying to @DrDavidCook1971 @Atul_Gawande @ShaunLintern

        A bigger safety risk is time, the more time a nurse or doctor has to spend on an electronic system entering data, requesting tests vs previous ways reduces patient contact time

        0 replies 0 retweets 5 likes
      4. End of conversation
      1. Sylvia Nan Cheng, MDes‏ @sylvianancheng Sep 28
        Replying to @Atul_Gawande

        @GenderEconomy @UofT_BEAR @Kennedy_School Looking forward to research on the #genderbias training backlash. Beyond current unrest, I am curious about its long term effects (as seen in EMR data), hopeful these intentional changes are moving the needle by shaping norms. #BAD2018

        0 replies 3 retweets 3 likes
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      2. Richard Corbridge‏ @R1chardatron Jul 29
        Replying to @Atul_Gawande

        @DitLeeds & @CCIOLeedsTHT & @SarahAMoorhead & @martinjwaugh Interesting read, would love our stats on this?

        1 reply 1 retweet 1 like
      3. Martin Waugh‏ @martinjwaugh Jul 29
        Replying to @R1chardatron @Atul_Gawande and

        Two obvious areas to review being eObs and eDAN/eMeds. Almost makes me wish to dust down my SQL skills. Wonder what @Colizobble is doing on his next university based Thursday?

        0 replies 0 retweets 3 likes
      4. End of conversation
      1. New conversation
      2. Quantitative Innovations‏ @QuantInnovate Jul 27
        Replying to @Atul_Gawande

        Is the relationship correlation (association) or causal?

        1 reply 0 retweets 2 likes
      3. Ken Milne‏ @TheSGEM Jul 27
        Replying to @QuantInnovate @Atul_Gawande

        Only association. Observational study design not a RCT. Causation cannot be claimed. Other unmeasured confounders could be responsible for the observations. Also temporal bias could have impacted the results.

        0 replies 0 retweets 4 likes
      4. End of conversation
      1. pat brennan‏ @brennanpat2010 Jul 27
        Replying to @Atul_Gawande

        The best thing about retiring from nursing has been leaving the ball and chain of the EMR behind. #freefromtedium

        0 replies 0 retweets 5 likes
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      2. john Veall‏ @docveall Jul 27
        Replying to @Atul_Gawande @drlauraduggan

        The other unanswered question is if you had spent the same amount of money in other areas (additional staffing, equipment, etc...) would there be a comparable or even larger effect

        1 reply 0 retweets 9 likes
      3. 1 more reply
      1. Chris M Hughes, MD‏ @cmhughesmd Jul 27
        Replying to @Atul_Gawande

        "How to stop worrying and love the EHR," but who would play Dr. Strangelove?

        0 replies 0 retweets 4 likes
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      1. Umbereen Nehal‏ @usnehal Jul 27
        Replying to @Atul_Gawande

        That deaths go UP initially is something I experienced when I had a minor surgery during a simple EHR upgrade. A potentially fatal double dose of a medication was almost administered to me by an anesthesia team. No one knew where to look for meds already given.

        0 replies 0 retweets 4 likes
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      1. Recovering Daughter‏ @girl_recovery Jul 27
        Replying to @Atul_Gawande

        That’s right. And when the “system is down”, they don’t have access to vital medical records which could prevent errors and sentinel events

        0 replies 0 retweets 4 likes
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      2. Other Musings‏ @other_musings Jul 28
        Replying to @Atul_Gawande

        It’s not an EHR issue, it’s a human interface design issue

        1 reply 0 retweets 2 likes
      3. David Palmer‏ @DrDavidPalmer Jul 29
        Replying to @other_musings @Atul_Gawande

        Nailed it.. clinician acceptance is all in the user interface.

        0 replies 0 retweets 1 like
      4. End of conversation
      1. Jason Mullenix‏ @MemphisOB Jul 27
        Replying to @Atul_Gawande

        EMR simply does not make health care better.

        0 replies 0 retweets 2 likes
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      1. Marilyn Peche‏ @docmcdevelina Jul 27
        Replying to @Atul_Gawande

        Interesting, we are at the beginning of the learning curve

        0 replies 0 retweets 2 likes
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