Daniel Essin, MA, MD

Without possessing and using a scientific mind, physicians are limited to functioning as technicians. Any case, not only the most difficult, can benefit from a scientific approach.

Imagine that you're going to your favorite restaurant tonight for their chef's signature dish. Assuming the most likely sequence of events, you will arrive, get seated, place your order, enjoy a great meal, and then depart. There is an implied contract between you and the chef: the chef will prepare a perfect meal, serve it on time, and provide superb service and you will exhibit good manners, pay the bill, and perhaps extol the restaurant to your friends. ...Many aspects of healthcare delivery and business operations can be re-imagined in terms of this metaphor.

An electronic health record (EHR) is a lot like a swimming pool. The chart notes and other entries are analogous to the water in the pool. If every entry was complete, accurate and timely, it would be as if the pool had been filled with pure spring water. In reality, not every entry is pristine; these are the ones that constitute the pollution.

The iPad doesn't have a file system like your PC or Mac. This is one reason it’s no substitute for a real computer. Each app has its own private storage area, even file-sharing services like Dropbox. I find that I need five e-book readers because their features differ, but I often want to read the same book in each. The result is that I end up with five copies of the book.

Two factors will determine whether the iPad turns out to be more than a novelty gadget: How well it works for what the techies call "content creation" (think documentation or charting) and how well it can interact with other computer-stored data and files.