Thanks Stef, Would be happy to get them involved in discussion, if the openEHR clinical community had begun to debate any of it!
As no related issues debated just yet..anyone want to kickoff? Regards, Tony ________________________________________ From: openehr-clinical-bounces at chime.ucl.ac.uk [openehr-clinical-bounces at chime.ucl.ac.uk] On Behalf Of Stef Verlinden [[email protected]] Sent: 08 April 2010 21:36 To: For openEHR clinical discussions Subject: Re: Re NEJM article: Can Electronic Clinical Documentation Help? 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. 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