Journal of the Oklahoma State Medical Association JOSMA Volume 106, No. 10, October 2013 : Page 3

J. Michael Pontious, M.D. Hacking Medicine... Makes people anxious when I speak of “hacking”. I suppose the word has come to mean something illegal, something done on the sly, something deceitful…. Let me explain, that is not how I use the word. I see the ability to “hack” something as a gift, as a desired skill, as a perspective that takes the status quo and manipulates it into another way, I would presume, more efficient way of performing the skill. I am sitting outside the Intensive Care patient room recently...I note that one of my young consultants has gone to the bedside of my comatosed patient and pulls out his cell phone...being the “techie” that I am, I cannot resist peeking around the corner. I guess my assumption was that he had some program on his phone that was going to morph into the Medical Tricorder from Star Trek to evaluate the patient. In reality he was checking pupillary reflexes with the light app on his cell phone. The application was developed to replace the typical flashlight...for thirty years I have been sending the nurse on a wild goose chase to find me a traditional flashlight... never once has she recommended that I use my cell phone…and never once had it occurred to me...my consultant provided me with a “hack” making my life easier and allowing me to practice a bit more efficient medicine. Some are going to look at my example and say “Pontious, I have been doing that for years….” others are going to say “I have never thought of that...where do I download that application…” I spent thirty minutes writing a program on my EMR that allows me to order the lab tests necessary to evaluate my patients for the various hypercoagulable states. For years, I had a reference that I always looked up to remind me of the list of lab tests that needed to be ordered. I had even written them down on a sticky note which worked until the sticky wore off and the note was whisked away by the housekeeper. Now with the pressing of one button each test is chosen and linked to the diagnosis that gives legitimacy to why I am ordering the test. It seems I have spent thirty years trying to find the time to put together this list. Sure, I memorized part of it, but did not have the lab codes memorized….and always seemed to miss one or two (or even three or four...but I am not admitting that) of the tests when I relied on my memory...so I resorted to a “hack”. I need to warn you that some of my “hacks” are disruptive in nature and take a bit of trauma from the powers that be. Those of us in primary care have fax after fax after fax of companies that have called our patients selling them medications or the newest orthopedic device or the most wonderful new personal mobility device and (my most favorite) diabetic supplies. I am convinced in our current system there must be huge monetary motivation in diabetic supplies. And a good sell job on the phone to one of my demented diabetic patients sounds like a good thing, so the Some are going to look at my example and say “Pontious, I have been doing that for years….” An editorial is a column of personal opinion that may or may not reflect the official position of the OSMA. OSMA Journal • October 2013 • 383

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