Monday, October 10, 2011

The Art of Medicine: Evidence-Based vs. Evidence-Enhanced

Medical care has evolved from using the individual practitioner’s training belief system, and own personal bias to using data, studies, and evidence to make appropriate decisions. This more scientific approach has yielded better results and more rational treatment programs.

However, in the mantra of “double-blind-controlled study," there is another side of medicine that needs to be addressed. This is the “Art of Medicine”.

Medical care not only includes scientific assessments and treatment protocols but also the human side. Patients come for the best scientific care but also for compassion, empathy, measured opinions, and guidance.

The Electronic Health Record (EHR) gives access to the data, but not the whole story.

By combining “evidence-based medicine” and the “art of medicine” you will achieve “evidence-enhanced medicine” giving the patient a holistic approach for which they are grateful. There is a reason other than scientific medical care that patients are nostalgic for their “own doctor."

Monday, October 3, 2011

Why Your EHR is "Creepy"

The definition of creep according to Wikipedia is the tendency of a solid material to slowly move or deform permanently under the influence of stresses.
The software you are dealing with is in a constant state of flux leading to multiple changes that may inadvertently lead to user dissatisfaction.

1.      Version “creep”—constant upgrading of the software with leads to potentially unwanted changes.
2.      “Creeping Elegance” ---- developers seeking the “HOLY GRAIL” of perfect software while detracting from its fundamental utility.
3.      Government “Creep”------ new rules every month that forces the software to make changes that may or may not be in the actual user’s interest.
4.      Payment “Creep”---“meaningful use” is a classic example of making programmatic changes to reimburse the client for their investment. Whether the purchaser recoups their investment remains to be seen.
5.      “Enterprise Creep”---- the institutions purchases an enterprise computer system (full hospital system) not designed for the particular end-user ( i.e. –no specific ED module). This may force a relatively satisfied user to reinvent the wheel.

The goal is to find an end-user friendly product that helps the provider rather than putting up a spider web of obstacles.