Thanks Tony, great article. Is it an idea to invite the authors of this article to participate in the discussion & debate (or otherwise) within the openEHR community?
Cheers, Stef Op 7 apr 2010, om 19:14 heeft Tony Shannon het volgende geschreven: > For your interest... > > ## > You may be interested in this article just out from the NEJM. > "Can Electronic Clinical Documentation Help Prevent Diagnostic Errors?" > http://content.nejm.org/cgi/content/full/362/12/1066?ssource=hcrc > > It contains much thought provoking analysis of the current challenges in > the EHR space. > Its a brief 4 page article that I would recommend to you.. > > Here are some selected excerpts, that are particularly pertinent as the > push for the development of key archetypes continues.. > > > "EHRs promise multiple benefits, but we believe that one key selling > point is their potential for preventing, minimizing, or mitigating > diagnostic errors. Admittedly, evidence to support the existence of such > a benefit is currently lacking, and our hypothesis runs counter to the > sentiments and claims of many physicians, who argue that electronic > documentation in its current incarnation is time-consuming and can > degrade diagnostic thinking" > > "The problem of having too much information is now surpassing that of > having too little, and it will become increasingly difficult to review > all the patient information that is electronically available." > > "Free-text narrative will often be superior to point-and-click > boilerplate in accurately capturing a patient's history and making > assessments, and notes should be designed to include discussion of > uncertainties." > > "EHR systems should facilitate the documentation of evolving history and > ongoing assessment." > > "The failure to effectively integrate the creation, updating, > reorganization, and inactivation of items on problem lists into the > clinician's workflow has been one of the great failures of clinical > informatics." > > "Diagnosing illness is one of our most important professional > responsibilities, and patients justifiably expect us to perform this > difficult task well. Electronic documentation represents a pivotal tool > that can help us to fulfill this responsibility. " > > ## > Also of note, see John Halamkas response to this article that proposes a > daily wiki entry for patients in their EHR, based on each days entry > would have a multidisciplinary entry with one physical examination, one > assessment, and one plan. > > http://geekdoctor.blogspot.com/2010/04/rethinking-clinical-documentation.html > > ## > > Hope these might be of interest +/- provoke some discussion & debate on > EHR development and the most effective role of archetypes at this time... > > Regards, > > > Tony > > > Dr. Tony Shannon > Consultant in Emergency Medicine, Leeds Teaching Hospitals > Clinical Lead for Informatics, Leeds Teaching Hospitals > Chair, Clinical Review Board, openEHR Foundation > +44.789.988 5068 tony.shannon at nhs.net > > ******************************************************************************************************************** > > This message may contain confidential information. If you are not the > intended recipient please inform the > sender that you have received the message in error before deleting it. > Please do not disclose, copy or distribute information in this e-mail or take > any action in reliance on its contents: > to do so is strictly prohibited and may be unlawful. > > Thank you for your co-operation. > > NHSmail is the secure email and directory service available for all NHS staff > in England and Scotland > NHSmail is approved for exchanging patient data and other sensitive > information with NHSmail and GSI recipients > NHSmail provides an email address for your career in the NHS and can be > accessed anywhere > For more information and to find out how you can switch, visit > www.connectingforhealth.nhs.uk/nhsmail > > ******************************************************************************************************************** > > > _______________________________________________ > openEHR-clinical mailing list > openEHR-clinical at openehr.org > http://lists.chime.ucl.ac.uk/mailman/listinfo/openehr-clinical
