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The Nellie B. Connally Breast Center is named for a breast cancersurvivor and a tireless advocate of breast cancer awareness. It is oneof the largest multidisciplinary breast centers in the U.S., offeringmany innovative new therapies. The Breast Center has comprehensivetreatment for all types of breast cancer, including a world-renowned inflammatory breast cancer clinic. Patients also have access to plastic surgeons for breast reconstruction procedures either during or after mastectomy.Please complete the Patient Self-Referral form.You will be contacted by a Referral Specialist to collect theadditional information required for confirming your appointment.New Patient Checklist (pdf)

First, recognize that “Digital Transformation” (DT) can be defined many ways. It can be as simple as replacing legacy tools and manual processes with newer and standardized applications. It could be as massive as end to end automation of core business processes or functions. They key goals these definitions share are that process and technology are intertwined in the solutions, and are meant to streamline, scale, or enhance a process, operation or entire business.Good examples can be as simple as elimination of non-digital or non-process integrated data, such as an application process taking printed PDF or other forms and people-centric, redundant data maintenance to a fully online solution that streamlines the process, eliminates errors and redundancies and makes the process more efficient. Fill out new patient forms at a doctor’s office and you will see the need for DT. Or use Alexa to order a pizza from Domino’s, another example of transforming how a business process is done.A more complex scenario would be an end to end strategy of linking processes and people with unified tools/applications, and applying newer or more advanced technologies to automate or get to a “next level” of their processes and technology. These could be simple algorithms, integration to various external api’s to bootstrap key technologies and processes, and various implementations of AI woven in to gain efficiencies and accuracy. Nissan, Porsche, Netflix all have case studies and stories to tell on this.

Not only the paperwork burden, but also the burden of “EHR Meaningful Use” as mandated under PPACA (ACA/Obamacare). I had formulated a tremendously useful structured interview and examination format that I used in my clinic; many patients said that the 20–30 minutes I spent with each new patient was the most comprehensive medical history and examination they had ever had. Whenever I went on vacation and hired a locum tenens (temp) doctor, they often praised my system and asked for copies of the forms so they could implement them when they had practices of their own.Once “Meaningful Use” was required, I was excited to streamline my systems still further and I eagerly started to try out different types of Electronic Medical Record software. Of course, under Obamacare, I could only use software that had been approved by CMS. I tried four different systems in six years. To my dismay, the software was full of bugs and complicated, unnecessary steps, and accessing patient information and records of prior visits was consistently difficult and unintuitive. Literally thousands of hours were required on my part and my staff’s to accomplish the conversion of patient records into each system. The software and equipment required to run it cost me, all told, over $100,000. The quality of care I provided necessarily deteriorated.And the worst part? The EMR requirement was supposed to provide for instant interoperability between different clinics, but the programs could only transmit patient demographics and coded diagnoses between systems. To send or receive patient records, we had to print them out in PDF or on paper, which often ran hundreds of pages because of the way the software stored each record, and then either burn a disc, physically hand the paper records to the patient, or transmit them via fax. This last is because old-fashioned telephone-line faxes are okay under HIPAA, but transmitting a password-protected PDF is not. The idiocy of regulations!As I developed progressive inflammatory arthritis in my hands, the hands-on care I was providing to my patients began to deteriorate. I might have hired young chiropractors with intact hands and taught them my systems, but the computerized medical records were causing the mental services I provided as a chiropractic physician to deteriorate in quality as well. And I was spending more and more time filling out forms and talking on the phone to clerical personnel at insurance companies, justifying treatment plans and MRI and CT scans for patients who needed them.Sadly for me, my personal medical physician was undergoing the same sort of nightmare deterioration of her clinical systems due to EMR requirements, and that’s a big part of the reason my inflammatory arthritis was misdiagnosed until the damage was already well advanced. I did have good long-term disability insurance coverage, so I was able to retire at a relatively young age and pursue a writing career, but I would far rather have continued to practice excellent chiropractic medicine well into old age.