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A Call for Intuitive EMRs

Scott Mace, for HealthLeaders Media, July 24, 2012

But I don't see any standardized workflows on the horizon. Nurses in two departments of the same hospital often don't have the same workflow for administering medication. How can an entire healthcare industry be expected to standardize workflows?

The free market has its own way of imposing standardized workflows on healthcare. It's called mergers and acquisitions. But each merger or acquisition brings even more risk to the endeavor, as executives strive to merge two workforces. More massive consolidation also means a lessening of responsiveness to local market conditions.

The media, myself included, subtly encourage the big getting bigger, guilty of paying more attention to the largest healthcare systems, where ample money and resources permit early and well-planned adoption of the latest and greatest technology. But those systems "live in rarified air differently than we do," says Charles E. Christian, CIO of Good Samaritan Hospital, a 237-bed hospital in Vincennes, Ind., serving a 10-county area of 250,000.

Christian is working on Stage 1 of Meaningful Use. "I won't attest [for Meaningful Use] until September of this year," Christian says. But rather than feel a sense of accomplishment at that point, this rural hospital instead faces the starting gun of reaching attestation for Meaningful Use Stage 2. And it is daunting. Final rules are now expected at the very end of summer or even a little later.

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1 comments on "A Call for Intuitive EMRs"


Alton Brantley, MD,PhD (7/25/2012 at 12:13 PM)
Pam McNutt and Chuck Christian have hit the nail on the head. In particular, the engagement of the federal government into the development of EMRs, with the bureaucracy of federal design, certification requirements, approval of certification bodies, and the introduction of civil and criminal penalties, has created a situation where the practice of medicine is subordinated to regulatory fossilization. Alternatively, what should have been sought was a standardization of interoperability and an evolvable, versionable content structure that would enable and foster the development of exactly what Pam desires. Standards should be interoperable and overlapping so that not every software system need be upgraded to interoperate effectively - a sliding window of versions and content that enable all parts of a multi system environment to operate as each component is changed out and upgraded. Finally, coding standards that are baroque in nature like the ICD codes need to be phased out and replaced with taxonomies built in machine-parsable grammars.