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 ********************************************************************************************************************
