Friday, February 27, 2009

Government Push for Electronic Medical Records

"The economic stimulus plan currently being considered by Congress allocates $20 billion to health information technology such as electronic medical records (EMRs)...mixed opinions"..."'EMR is the worst thing that has happened to me professionally in over 25 years of practice' says ..."..."'I absolutely love our EMR,' says a nephrologist"

I work at a big hospital as an IT professional. Having gone through a few projects responsible for data model design, I know exactly what a good model and hard work mean. A few years ago a gynecological cancer project was handed to me. The data analyst, representing the users, already did excellent work in gathering requirement and use cases. But to implement that correctly in my Oracle database still took a lot of thinking. For instance, there're more than a hundred input fields that are like:

* Option1
* Option2
* Other
If other, specify details _____________.

Programmers and DBAs always love fixed fields and hate free text because free text is hard to program and difficult to search. But users are our God's and we have no choice. The above example must be implemented as multiple fixed choices using a reference table *plus a free text field* in the data table! When there're 100 of them, you get tired quickly.

The quoted Medscape article says primary care physicians tend to hate EMR and specialists generally embrace it. The former has to face a more undetermined situation when patients first come in. No doubt there's tension between their needs and programmers' pitiful preference.

We all know the IT in healthcare is the servant for doctors and nurses. If we don't constantly remind ourselves of this role, we're not living up to tax payers' high expectations and their precious contributions to keep us employed.

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