Dr. Hesham A. Hassaballa on the Digital Healthcare Equation

About the Author

Hesham is a practicing Intensivist with 17+ years of clinical practice. He is board-certified in internal medicine, pulmonary medicine, critical care medicine, and sleep medicine. Hesham is a Regional Medical Director for Sound Physicians’ critical care practice in the Midwest. He leads and oversees ICU clinical operations in Illinois and Missouri, and he is Medical Director of Respiratory Therapy and Pulmonary Rehabilitation at Rush-Copley Medical Center in Aurora, IL.

He’s an Assistant Professor of Medicine and Course Director for Rush University Medical Center, and he serves as a peer reviewer for multiple medical journals. He has presented research a number of times at national meetings and has also published numerous articles in peer-reviewed medical journals. In addition, Hesham is a prolific writer, with articles appearing in newspapers and websites globally, and has published a medical thriller, “Code Blue.”

Hesham has a dedicated column on Medika Life for his articles, you can follow his work here

Hesham’s experience with Digital

I am a Pulmonary and Critical Care specialist practicing in Illinois. I am Medical Director of the Critical Care program in my hospital and an Associate Regional Medical Director, implementing critical care programs in multiple states in the Midwestern United States. When I first began practice in the ICU, it was the most technologically advanced part of the hospital. But that was not saying much. 

Our documentation was still on paper and pen. Physician orders had to frequently be deciphered by multiple people to ensure the correct drug or test was ordered. I clearly remember a major error being committed because a nurse misread a physician’s illegible handwriting. Invasive procedures were done by feel, and complications were commonplace and sometimes deadly. 

The first major sea change with respect to technological advances was the electronic health record, beginning with computerized physician order entry. No longer is a major error just a physician’s illegible chicken scratch away. It was a game-changer. Orders were transcribed and sent to the appropriate department in a much more timely manner. Patient care was greatly improved. 

Then came electronic documentation, which was another game-changer. It always amazed me that a physician colleague would take the time to write a note in the chart and have that note be completely illegible, so no one could understand what he or she was thinking or doing with a mutual patient. With the EHR, this was also no more, and gone were the days of straining my eyes and turning the chart on its side to try to interpret what a physician had written. 

With respect to direct patient care, the technological advances have exploded. Ultrasound guided invasive procedures revolutionized the field, and made those procedures much safer for patients. Much of the hemodynamic monitoring we did was also invasive, and now I can get detailed and sophisticated measurements completely noninvasively  

The revolution in technology continued with the advent of the smartphone. All the most up-to-date medical information and literature is available in an easy-to-use app. Prescribing medications can be done electronically in the palm of my hand. My patients absolutely loved the fact that, before I left the exam room, their prescription was already sent to the pharmacy. Today, I have the entire EHR on my smartphone as well, and documentation and information gathering has never been easier. 

Point of care ultrasound is also now an app, and I can do a bedside echo with a probe that plugs into my phone and fits in my pocket, with the image being uploaded to the cloud and integrated automatically into the EHR. Of all the technological advances, these two things – the pocket EHR and pocket ultrasound – are the things I use and benefit from the most today. 

That said, all of these technological advances are not without their pitfalls. Yes, with the EHR, notes are legible. But, you can generate a 15 page note that says absolutely nothing with an EHR. Yes, it’s nice to have an ultrasound in my hand. It is still not as clear and beautiful looking as the image that is generated by the big behemoth machine that needs to be rolled into the room from the department. 

Furthermore, in the middle of the Covid-19 pandemic, I was hesitant to bring in my own smartphone and ultrasound probe into the room and potentially contaminate myself. Sure, I can get multiple hemodynamic measurements noninvasively, but are those measurements clinically meaningful? And, the more technologically advanced we become, the more likely we risk becoming further detached from the patients themselves, and that can’t be good for the physician-patient relationship. 

Just in my lifetime, the technological advances in my field have been breathtaking. The question remains, how do we harness this incredible advancement and still keep the healing touch for which many of us answered the call of healthcare in the first place? 

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