There’s a reason why our medical records systems don’t work and that reason goes back quite a way. As I’ve mentioned before, it goes back to when IT people started implementing the paper records in computers, assuming the paper records contained a complete model of the medical management of the patient, which they didn’t. Automating [...]

After watching Apple vs Predator, a short YouTube video, I had a blinding flash of the somewhat obvious and this is it: no other interface but the iPhone/iPad interface can seamlessly transfer to a virtual surface and gestures. Let’s expand on this. If you’ve seen “Minority Report”, the movie, you must remember the interface Tom [...]

Every project and initiative in healthcare IT can be classified into one of two types: interconnection and the rest. Interconnection projects, as the term indicates, all have in common that they involve improving just the exchange of data and nothing else, by actually interconnecting two or more systems, or by creating some standard that is [...]

The main obstacle to getting a better electronic health care record off the ground is the following. Hospitals (or large primary care organizations, for that matter) generally do not buy anything but complete systems with wall-to-wall coverage of functionality, which in turn leads to major upheavals at every system change and generally an almost total [...]

I’ve started to do mockups of the iotaPad interface, so I can illustrate the workflow of the iotaMed journal. I think those mockups are needed, since it’s very hard to illustrate how a medical record should work, unless you can see it in action.

Putting my money where my mouth is, or my wiki where my iota is, I decided to wikify the effort. But first it needed a name and I came up with “iotaMed” which stands for “Issue Oriented Tiered Architecture for Medicine”. You can find the wiki at iota.pro. Be there.

To summarize where the medical record is and where it is going, we could say the following. And if we can’t, please tell me why not. The frontend of current medical records systems simply don’t work in practice. They’re hard to use and are unsuitable to help in ongoing work. The only thing they do [...]

If we use “issues” as the top level item in the EHR, instead of the “encounter”, it comes naturally to attach confidentiality attributes to the issue instead of the department, doctor, or encounter. That’s a huge improvement. Let’s take an example to show why. As things are in current systems, confidentiality walls or borders are [...]

In my last post I described the positioning of the SRR record and I also painted it as a form that can either be predetermined in the form of a clinical guideline record or a free form record to which the doctor can add steps, or a mixture of both. Since we don’t want to [...]

In my last post, I arrived at the conclusion that the main element in the electronic healthcare record should be a list of problems and each of those problems should be an SRR, that is a document that is updated with  the most recent data pertaining to this problem, not a document that gets replaced [...]