CancerNetwork Members: Login | Register
CancerNetwork SearchMedica Medline Drugs

Powered by SearchMedica

 
PUBLICATIONS
NEWS
PODCASTS
TOPICS
BLOGS
NURSES
PATIENTS
JOBS
CONFERENCES
CME
SUPPLEMENTS
 

Home » EHR

 

EHR Systems Should Be Taking Larger Strides, But Aren't

By Daniel Essin, MA, MD | August 27, 2012

When your child takes that first step, wild excitement ensues. The phone lines light up. You spread the news to the grandparents, aunts, and uncles. It makes no difference that they fall after the second step, the milestone is noteworthy. A similar phenomenon occurs the first time many people succeed in doing something with a computer.

Whatever was accomplished takes on magical properties and many feel an irresistible urge to spread the good word; they proselytize others to join their cult of their newly embraced computer/software belief system. Neither the computer nor the hardware can do any wrong. It can crash, freeze, loose work, consume hours of you time as you apply updates, and reboot and reboot yet again. All is forgiven. Your willingness to glory in a stumbling child or and unreliable computer system does not alter the fact that the child is not ready to walk on their own or that the computer is not ready for mission-critical applications.

(MORE: With EHR Use, Computer Literacy Misses the Point)

Why worry about this? Two reasons come to mind. First, the country has a lot riding on the expectation that today's computer systems are more reliable and capable than they really are. Second, I believe that it is possible to do better. If it were not, then our only option would be to continue business as usual — live with the interruptions, lost work, errors and outages, and institute manual fail-safe procedures that attempt to detect critical errors, omissions, and failures and correct them.

Am I the only one that holds this view of current technology? The short answer is no. Jason Gorman says in "Back To Basics - Hype-free Principles for Software Developers": "As I read more… It seemed to me as if what we’d mostly been doing these last 40 years or more was coming up with new names for software development principles and practices that those in the know were already doing."

In other words, the names of the common development techniques have been changed, but not their substance. Those techniques produced unreliable systems in the past and they continue to do so. Researchers are constantly exploring new techniques but there is no national IT policy to incentivize or promote the widespread adoption of improvements.

Companies that manufacture computer hardware and software know enough not to trust their own products. This was made plain to me in 1991 when we bought a computer from Sun Microsystems to run an interface. The Terms and Conditions attached to the system contained a warning that it was not to be used for any life-critical or mission-critical application such as controlling a nuclear power plant or flying an aircraft. Consider that only a few years before, our facility installed a critical care system. It was connected to all the monitors, IV pumps, and ventilators — granted, the individual devices still had their own alarms and I do not remember whether those were left enabled or whether the task of generating alarms was delegated to the critical care system but that system used the very same Sun computers — the one with the warning that they not be used in life-critical applications.

And a personal example: I use a lot of computer hardware and software — probably more than you do. As I explore new software, more than 20 percent of the time I discover a crash, flaw, or other problem that renders software unusable. One or another of my Macs and PCs freezes or crashes at least once a month as well. Every week an average of two hours to three hours is consumed downloading and applying software updates. And finally, in the past 35 years on more than 2,000 occasions I have had the experience of reporting a problem or failure of software or hardware only to be told, "You're the first person that has ever reported this." I may have been the first to recognize or report problems but certainly not the first to experience them.

Every failure can be rationalized or excused. That's true whether it's a medical failure or a computer failure. Physicians believe that the incidence of medical failures can be reduced and have some ideas about how to go about it. I'm sure that the folks that produce computer systems have similar ideas but, if their development techniques are 40 years old then those techniques are the equivalent of "baby steps." If your child was not walking by age 40, most would call that developmental delay. Would you still be as excited when your 40-year-old fell after a single step as you were when your infant was taking that first step?

The only reasonable conclusion is that computers and software are exhibiting developmental delay. It's time to cool our unbridled enthusiasm and pay more attention to providing remedial help and preventing birth defects.

Find out more about Daniel Essin and our other Practice Notes bloggers.

 

Join the Conversation

Want to join the conversation? If you're a healthcare professional, we'd like to hear your comments. Just sign in or register today to become part of our growing, online community.

More from Daniel Essin

Qualitative Evaluation Can Help Keep Your Eye on the EHR Ball

EHRs in the Cloud: Hiding Flaws Don't Make Them Disappear

ONCHIT Direct Project a Win for Health IT

The Yin and Yang of Data and the Impact on EHRs

EHRs and Interoperability: Back to the Drawing Board

EHR Construction Doesn't Always Include the Right Tools

The Medical-Industrial Complex

Can Physicians Apply Preventive Medicine Knowledge to EHR?

EHRs: Weighing Form vs. Function

The Ethical Dilemma Created by EHRs

Waste Avoidance: The New Mantra in Healthcare Spending

Reimagining Personal Health Devices

EHR-stored Health Data: Access Issues Confront Cloud Innovation

EHRs a Prime Example of Medicine's 'Software Crisis'

Meaningful Statistics — Can Your EHR Produce Them?

Imagining a Day in Medical Practice with a Possible Future of EHR

EHR Interoperability: I'll Know It When I See It

'Content Neutrality' and Why It Is Important for EHR

The Perils of Over Specification and Underspecification in EHR Systems

IBM's Watson: Has the Time Come for Expert Systems in Medicine?

With Any EHR, Theory is Important but So is Practicality

Doctors Need More Control over the Care Process and EHR is Little Help

With EHRs, Less Patient Data May Be More — Up to a Point

Improve EHR Systems by Rethinking Medical Billing

With EHRs, When Seeking Clarity, Begin at the Beginning

Pondering the Justification for the Federal HIT Push of EHRs

Words Can Be a Window into Fuzzy Thinking about EHRs

One Physician’s New Year's Resolutions

EHRs Only One Victim of Reaction vs. Reason in Healthcare

ICD-10 Shouldn’t Dictate Patient Care or EHR Design

Who Really Benefits from the ICD-10 Transition?

Medical Coding’s Intent is Sometimes Lost in Translation

Medical Informatics — The Debate of Art vs. Science Is Over

Is the EHR Glass Half-Full or Half-Empty?

EHRs and Cars: Don’t Let Perception Cloud Purpose

The Probable Consequences of EHR Certification are Scary

Will an EHR Ever Last as Long as a Patient?

Clinical Quality Measures: Meaningless in Measuring Quality

Interoperability in Healthcare – Easy to Say, Hard to Do

EHRs: Weighing Incentives and What's Best for Patients

With EHRs, Sometimes Less is More

EHR Systems Should Be Taking Larger Strides, But Aren't

Meaningful Use Marches On

To Be or Not To Be an EHR in the Cloud

EHR Cloud Computing Meets Moore's Law

With EHR Use, Computer Literacy Misses the Point





CancerNetwork on Facebook


 
TOPIC INDEX

Cancer Types

 
  • Breast
  • Breast (HER2+)
  • Breast (Triple-Negative)
  • CML
  • Colorectal
  • Gastrointestinal
  • GIST
  • Genitourinary
  • Gynecologic
  • Head & Neck
  • Hematology
  • Kidney (Renal Cell)
  • Leukemia
  • Lung
  • Lymphoma
  • Melanoma
  • Multiple Myeloma
  • Ovarian
  • Prostate
  • Sarcoma

Supportive Care

More Topics

  • Bone Metastases
  • End-of-Life Care
  • Palliative Care
  • Ethics in Oncology
  • Practice Management
  • Practice & Policy


All Topics 


 
   SEARCH MEDICA RX
   Browse drugs by name:
A B C D E F G H I J
K L M N O P Q R S T
U V W X Y Z All      
   Search for drugs:
Search

 

 
FROM PHYSICIANS PRACTICE
Five Steps to Improving Patient Access
Judy Capko,  May 21, 2013
Patient access is getting increased attention through reform initiatives. Here are five steps you can take to make sure patients get appropriate access to care in your office.
Growing HIPAA Threat – Ignore Windows XP at Your Own Peril
Marion K. Jenkins,  May 21, 2013
Chances are good that you have some major ticking software time bombs lurking in your medical practice's computer environment, namely Windows XP and Server 2003.
Finding Physician Work-Life Balance in the Small Moments
Jennifer Frank, MD,  May 21, 2013
At my practice and at home, things are always busy. There's laundry or homework, or a patient with needs.
Three Areas to Reduce Costs at Your Medical Practice
Greg Mertz,  May 19, 2013
By taking a hard look at reducing costs for staffing, overhead, and technology at your medical practice, you may see increased physician compensation.
Dos and Don’ts for Starting a Physician Blog
Michael Woo-Ming, MD,  May 18, 2013
Starting a physician blog can provide your medical practice with marketing benefits, but it's important to do it right.
 

 

 
MOST POPULAR
  • Most Popular
  • Most Emailed
  • Most Recent
  • Dermatologic Adverse Events Associated With Targeted Therapies
  • Colorectal Lesions
  • “This Is My Last Day on Earth”
  • Slide Show: Squamous Cell Carcinoma of the Head and Neck
  • A 49-Year-Old Woman Develops Thickened and Bound-Down Skin
  • “This Is My Last Day on Earth”
  • Dermatologic Adverse Events Associated With Targeted Therapies
  • Colorectal Lesions
  • Recurrent Epithelial Ovarian Cancer: An Update on Treatment
  • US Task Force Recommends Breast Cancer Medications for High-Risk Women
  • Breast Cancer Screening, Risk, and Options for High-Risk Women
  • Colorectal Cancer Treatments and Therapy Innovations
  • A 52-Year-Old Man Presents With an Erythematous Lesion
  • Bone Metastases
  • Palliative Radiotherapy in Elderly Patients With Bone Metastases Improves Quality of Life
Click here to subscribe to our newsletter
 
COMMENTS
  • Most Commented
  • Most Recent
  • “This Is My Last Day on Earth”
  • Financial Toxicity, Part II: How Can We Help With the Burden of Treatment-Related Costs?
  • Preventing Exposure to Hazardous Drugs
  • Conflicts of Interest in Medicine: What About Ties to Payers?
  • Planning Treatment for Women With Recurrent Epithelial Ovarian Cancer
  • Rising PSA Level in a 46-Year-Old Man
  • Preventing Exposure to Hazardous Drugs
  • Cancer Metabolism as a Therapeutic Target
  • Study: Cholesterol Drugs Reduced Risk of Prostate Cancer Death
  • “This Is My Last Day on Earth”
Click here to subscribe to our newsletter


 
SearchMedica Search Result

Find peer-reviewed literature and websites for practicing medical professionals

CME on EHR
Evidence on EHR
Guidelines on EHR
Patient Education on EHR
Clinical Trials on EHR
Practical Articles on EHR
Research and Reviews on EHR
All "EHR" results


CancerNetwork | ConsultantLive | Diagnostic Imaging | Musculoskeletal Network | OBGYN.net | PediatricsConsultantLive |
Physicians Practice | Psychiatric Times | SearchMedica | Medical Resources

© 1996 - 2013 UBM Medica LLC, a UBM company
Privacy Statement - Terms of Service - Advertising Information - Editorial Policy Statement - UBM Medica Network Privacy Policy