Category Archives: #physicians

The Patient Waiting Room Rethought

Photo curtesy of Joseph Babaian (@JoeBabaian)

Yesterday Joe sent this tweet asking the #HCLDR family their opinions on the opportunities for improving the design within the above spaces.

My initial gut reaction, as many other people, was in pointing out the obvious. Things such as the TV, the picture on the wall, the chairs, the framed signed on the table, a lamp that is off, etc.

I even questioned the need for a waiting room? In theory, no patient should have to wait, and therefore, the waiting room could be eliminated.

As I began to ponder the question during my 2 hour drive today, I began to reframe the question in my mind.

Instead of asking what is wrong with the space or how to improve the design or the need for a waiting room, I started to think about challenges patients highlight.

Topics that we discuss during the weekly chats of #HCLDR.

What if we reframe and ask ourselves the following:

How can we help patients connect with one another?

In thinking about the space above (left picture specifically), I would rearrange the furniture to be in small circles or groups versus in a line.

Perhaps instead of the local news or Ellen on the TV I would show video’s from YouTube about nutrition, or the clinicians, or an important topic that is relevant to the community of patients congregating.

Maybe I would have a social worker in the space to help facilitate sharing, asking questions, and prepping/introducing those new patients with those that are coming back for a follow up.

Maybe the space should be more about sharing our stories, our common experiences, our fears, our questions with one another and use it as a learning opportunity? Maybe this is the space where we impact health literacy. Or address access to improved nutrition. Or share resources within the community.

Perhaps the space has nothing to do with waiting, but everything with building a tribe of patients that share a common thread and can learn from one each other’s experience.

Perhaps knowing a patient like me, the one sitting next to me, helps me realize that we do things like this.

We connect. We share. We learn. We grow.

Perhaps care at the N of 1 begins by connecting patients in the waiting room?

Let’s rename it the sharing room.

As always you can feel free to email me at or follow me on Twitter @cancergeek



EMR, The Epic Medical Regression


The EMR. Better to known to the world of healthcare as the Electronic Medical Record. The past few years being supported by the government with a series of funding opportunities to help drive adoption.

The emergence of the EMR was responsible for moving our information on patients from the complex world of 2D paper to the convenience and simplistic digital world of bits and bytes.

I remember when the EMR was first introduced into one of my clinics. The great premise was that everything would be at the tips of your fingers, easily searchable, actionable, and would improve productivity. No more faxing, no more copying, no more filing, no more lost papers.

Yet the promise has been far from met. I would say the first decade of EMR and implementation has just been more of the same. Taking paper and converting it to digital form. How do we take this form, this information sheet, and how do we shrink it to fit onto the screen.

It did increase productivity. It forced healthcare to expand their IT department, to rely on IT professionals to build out large teams, to work on interfaces, integration, patches, updates, and education. Building out programs to train the most brilliant minds in healthcare on how to information that used to be written with a pen to now be placed in a small little box, that you click on, then needing to type, hit enter, and move to click in the next box to repeat the process once again.

I prefer to call the EMR the Epic Medical Regression.

As one clinic began to implement into the new world of EMR, others followed suit because it was a “best practice.”

It was the leap into the digital age that was going to transform healthcare.

It is the single piece of technology that has made highly educated men and women completely frozen in their tracks. It has led to the need for new industries tracking patient satisfaction scores, patient experience, and engagement.

Today we continue to discuss interoperability, common language, and actionable data in healthcare.

Yet in every other industry the collection, utilization, sharing, and knowledge gained from information continues to move by quantum leaps. It leads to cost reduction, accessibility, and productivity.

Healthcare it leads to wait times, increasingly complex processes, inability to share/import patient information amongst hospitals, clinics, physicians, and competing organizations. We layer on more and more interfaces in hopes of duct taping systems together to work with one another. We add on more technology from more vendors that adds more layers.

We hear on all the reasons why we can’t do this or are unable to do that. It is because it is due to patient privacy. It is a highly regulated industry. Lives are at stake.

Again, EMR is the Epic Medical Regression.

Instead of starting with defining the problem, we jumped to adopting technology because everyone else was doing it. If you were a CEO, CFO, or CIO you wouldn’t be fired for investing in EMR, but you would be fired if you didn’t get an EMR.

Hasn’t the problem always been how do we care for the sick, the needy, the poor, the chronically and terminally ill in the most compassionate and timely way?

If that is the problem that healthcare needed to solve, why did we adopt EMR’s that made us more complex, less compassionate, and more difficult to find answers to our patient and communities most timely questions?

Why did healthcare adopt technology that forced regression in our ability to connect with patients when the rest of the world adopts technology that allows us to deeper connections between people?

Why did we adopt the Epic Medical Regression?

As always, you can feel free to contact me at: CANCERGEEK@GMAIL.COM or follow me on twitter @cancergeek