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 located [...]

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 [...]

In my previous post, I described the two kinds of data that I think I see in most, if not all, applications. The two kinds are the “state reflecting record” (SRR) and the “transformation additive series” (TAS). Cumbersome names, I admit, but if you have a better idea, let’s hear it.
A medical record, be it [...]

In my neverending quest to straighten out the electronic healthcare record, I have to introduce a view on data that is essential if I’ll be able to explain what’s wrong with the current model and how it should be fixed. As always when we’re in a mess with the design of systems, we climb the [...]

According to one Swedish trade rag, the US administration is looking admiringly to the Swedish model of IT in healthcare. I can’t find any US sources that confirm any of this admiration, so it may be more wishful thinking than reality. Please correct me if I’m wrong. They’re not mentioning sources, so it’s hard to [...]

This is a continuation on my previous post, “Evidence based vs anecdotal“.
I wrote an email to the main author of the chapter in “4th Paradigm”, Michael Gillam, and he graciously responded to my criticism by agreeing to everything I said and emphasizing that this is what they wanted to say in that chapter. He suggests [...]

I was doing the rounds at a nursing home out in the sticks the other day, and came to an old (all of them were old) woman with a urinary catheter and bag. Her problem, or rather her worry, was that the bag turned violet from the urine sometimes, but only the last week. The [...]

Like this company X I know, in the vertical application business. Same as company Y and Z I also know in the vertical application business, all of them doing healthcare applications like record systems, pathology systems, etc. Doesn’t matter exactly what they do or who they are, they are all representative of how that entire [...]

Medical technology is evolving and one particular area where a lot is happening is in robotic surgery. By moving the surgeon a couple of feet away from the operating table and into a comfy chair, we accomplish a few goals: relaxed surgeon, better view using keyhole techniques, filtering of movements, etc. But it’s only a [...]