Remake a paper chart in digital crazy? Maybe not. Health Care Renewal: Healthcare IT Failure and The Arrogance of the IT Industry

In reality, handwriting issues aside, there is little wrong with “the old medical chart” from an information science perspective. It evolved over a century or longer to serve the needs of its users. It is a simple document in terms of organization, containing sometimes complex information but in an easy to find form (when maintained by humans properly) and in a presentation style that recognizes human cognitive limitations in very busy, complex social environments such as patient care settings.

Its quasi-duplication in electronic form would serve medicine well.

I agree. And now the technology is finally here. Just look at the new SI magazine 2.0 that may be coming out on the iTablet

All the functionality of a paper chart, but e-enabled with video and rich design.

Let’s put together a project to do just that but better for medical records.


New patient info economy brewing? Brilliant comment by Dr. David Voran on the future of social media in medicine…

There’s no way I can see a global central clinical database working. Likewise the current models of distributed databases are chaotic and prohibitively expensive (monetarily and politically). Instead my best guess is that we’ll evolve into a social media integrative model.
For example, Twitter, Facebook, this blog along with other blogs can be configured to share information seamlessly. It shouldn’t be too long before an EMR installation would include the same type of processes where a list of other systems would be available in which to simultaneously post patient registration data (what I call person-level data) along with visit specific information (visit-level data).
In this model when a patient shows up that comes from another office that is using an EMR we’d search to see if that EMR could receive incoming posts. If so we’d select it and import the patient registration data, update it if need be (which would post back to the original contributing system). As the conclusion of the visit the new visit-level data would post back to the other system at the same time it posts to ours. Subscribing systems would see the note as an “outside note” but integrated with the medical record so if the patient returned the record would always be up-to-date.
It would be the responsibility of everyone to make sure of the accuracy and integrity of the patient data. EMRs that have junk in them would very quickly be “unsubscribed” and their users would suffer.

I’ve long thought that the social aspect of medicine was about to take off is some manner, but I was thinking more of physician to physician social collaboration as opposed to practice to practice. Dr. Voran outlines here really a new social economy of patient information controlled by the patient. There’s a potential business plan in here both for new EHR systems as well as the applications to support them, the connectors. Shows how the social sphere is could really be a kind of new online economic model for many vertical markets and types of information.