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Brainstorm Health: Electronic Health Records, AliveCor Mobile ECG, Amarin Fish Oil Drug

This morning, FORTUNE and Kaiser Health News published a report on our months-long investigation into electronic health records (EHRs), which you can read here. The story, by two of the best healthcare journalists in the business—FORTUNE’s Erika Fry and KHN’s Fred Schulte—is nearly 10,000 words, and once you get started, I’m pretty sure you’re going to want to read every last one of them. Indeed, this is one of the most compelling, surprising, and deeply disturbing stories about our healthcare system that I’ve read in a long, long time. It’s also one of the features I’m most proud to have published as FORTUNE’s Editor-in-Chief.

While, on first glance, the subject matter—your computerized medical charts—might seem to be the stuff of an eye-glazing white paper, this is a tale that directly touches you and your loved ones. It’s about what happens to your medical data when you visit the doctor or hospital—and about the unseen (and too often glitchy) technology that may affect the care you get, without you ever being the wiser.

This same technology—the EHR—also represents the single biggest practice change for doctors since the advent of the HMO, and it’s a huge contributor to another, often hidden, crisis in medicine today: the epidemic of physician burnout.

Doctors today spend an average of 5.9 hours of every workday dealing with electronic health records, according to a 2017 study in the Annals of Family Medicine. That’s well more than they spend with patients. (As crazy as that sounds, those data are backed up by other research, including this 2016 study published in the Annals of Internal Medicine. Or you could ask any doctor you know to give you an estimate of what she or he spends on these systems, and how much of that time is just plain wasted.)

Earlier this year, Medscape published a survey it conducted with 15,000 doctors on their personal experiences with burnout and depression. It offered a jaw-dropping assessment about the degree of frustration, hopelessness, and other emotional trauma faced by many of the same professionals who are tasked with taking care of the rest of us.

The suicide rate among physicians is more than twice that of the general U.S. population. And Medcape’s survey suggests that even apart from those who ultimately take their own lives (roughly one physician in the U.S. per day), a large number are in crisis: In the survey, 44% acknowledged being “burned out,” while 15% said they were either “colloquially depressed” or “clinically depressed.”

That burnout, by doctors’ own admissions, too often ends up affecting patient care. Thirty-five percent of those 15,000 respondents, in fact, admitted to being “easily exasperated with patients”; 26% said they were “less motivated to be careful with taking patient notes (e.g., history, filling out the EHR.)”; 14% said flatly: “I make errors that I might not ordinarily make.”

Pause on that data point for a moment.

While there’s no single cause to this epidemic of burnout, roughly a third (32%) pointed to a familiar culprit: “increasing computerization of practice (EHRs).”

How did we get to this point? How did we get to a place where so many physicians are handcuffed to a piece of technology they absolutely hate—tethered to non-intuitive systems that many describe as endless, numbing mazes of menus that take them away from hands-on patient care?

THAT is the crux of Erika and Fred’s remarkable story, “Death By a Thousand Clicks,” which I urge you to read. It’s a tale of unintended consequences on a scale that’s hard to imagine—a $36 billion federal investment that pushed doctors and hospitals to digitize medical records but set up no framework or rules for ensuring that all that data could—and would—be easily shared. (Imagine a financial system where everybody got an ATM card, but the cards only worked at a single bank.)

But this isn’t just about poor planning or government waste. Rather, it’s about people getting hurt, as Erika and Fred show. Though such incidents, injuries, and near misses related to EHRs often go unreported—or worse, are shielded from public view—the numbers we do know about will utterly shock you.

It’s amazing reporting, as you’ll see. And I’m thrilled that Erika and Fred will dive into their story in person at FORTUNE Brainstorm Health on April 2-3.

Erika and Fred will join leaders at Microsoft Healthcare, One Medical, the Biden Cancer Initiative, and other experts in a conversation led by Lloyd Minor, the Dean of Stanford University School of Medicine—which we’re pleased to say is an academic partner for our conference.

That’s just one of the essential, timely conversations we’re excited to have at Brainstorm Health. We’ll dig into where A.I. is making the biggest difference in medicine (and where it’s not) with Dr. Eric Topol, author of a profoundly insightful new book, Deep Medicine.

We’ll talk about the power and peril of big data with the leaders of the Mayo Clinic, IBM Watson, Tempus, Verily, Palantir, Intel, Color, Livongo, Project Ronin, and the Chief Data Officer of the U.S. Department of Health and Human Services, among others. We’ll explore the next new business models with Humana CEO Bruce Broussard, XCOM CEO Paul Jacobs, and Google’s inimitable Toby Cosgrove, and explore how R&D is rapidly changing with GSK’s Hal Barron.

We’ll be joined by 40 industry-leading (and industry-transforming) healthcare CEOs, more than 20 visionary business and nonprofit founders, change agents at eight top medical institutions, 10 of the smartest investors and venture capitalists we know, and so many more. And, as with every past year, we’ll have a bunch of wonderful surprises.

You can check out the lineup here. Hope to see you there!

Sy will be back with more tomorrow.

Clifton Leaf, Editor in Chief, FORTUNE
@CliftonLeaf
clifton.leaf@fortune.com

DIGITAL HEALTH

AliveCor touts mobile ECG data. Digital health firm AliveCor spoke with Fortune last week ahead of three new studies released over the weekend finding its mobile heart sensor platform can spur faster diagnoses of certain heart conditions, among other conclusions. “We’ve shown through clinically validated trials that our platform can improve detection, workflow, and lower costs,” AliveCor chief medical officer Jacqueline Shreibati tells me in an interview. The company’s next step is seeking Food and Drug Administration (FDA) clearance for the next version of its KardiaMobile ECG system, one which contains six leads and may be as accurate as conventional 12-lead ECGs for sensing certain heart abnormalities. (Fortune)

A ‘mental health tax’ for Facebook and Google? A group of U.K. lawmakers think Google and Facebook may be hurting our brains—and that the tech giants should pay for it via a 0.5% tax on their profits to help treat social media addiction. “Our Inquiry shows that there are aspects of social media which are positive—particularly for bringing together people with similar interests, reducing loneliness and helping communities stay in touch,” wrote lawmakers Chris Elmore and William Wragg. “However, there are also several aspects of social media that can have very damaging effects on young people’s mental health and wellbeing. Therefore, it is paramount that we protect young people to ensure they are kept safe and healthy when they are online.” (Fortune)

INDICATIONS

Amarin produces another seemingly impressive fish oil drug study. Drug maker Amarin made waves earlier this year when its prescription strength fish oil was found to drastically reduce the risk of deadly heart events like heart attacks for certain patients when used alongside statins. A new set of data released Monday also appears impressive—but, like earlier Amarin results, has elicited some controversy. Amarin stock was down 5% in Monday trading despite the new data in an “exploratory analysis” finding the fish oil pill, Vascepa, can significantly cut the risks of first, and especially subsequent, heart attacks and strokes. Some analysts have questioned aspects of Amarin’s clinical study designs (but that hasn’t done much to quell rumors of a potential M&A). (Reuters)

THE BIG PICTURE

The opioid tradeoff. The number of opioid painkiller prescriptions in America is falling—but patients are using them for longer, according to a new JAMA study published this week. On average, patients who use opioids used them for 4.9 more days in 2017 than they did in 2006. But this is a complicated issue; it’s possible that the individuals still receiving opioid prescriptions need the medication for more long-term pain problems, and the smaller pool of people receiving the treatments skews the results. (Fortune)

REQUIRED READING

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Will Your Tax Refund Shrink This Year? Here’s How to Find Outby Ryan Derousseau

Intel’s AI Plan Vs. Donald Trump’sby Adam Lashinsky

Investing in China: All Bets Are Offby Clay Chandler

Produced by Sy Mukherjee
@the_sy_guy
sayak.mukherjee@fortune.com
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