When it comes to using computational models for cognitive support - which can be argued to be one of the biggest gaps in today's HIT (see http://www.nlm.nih.gov/pubs/reports/comptech_prepub.pdf) -- innovative use of spreadsheets as reporting tools has enormous benefits.
If we really want to improve healthcare quality and efficiency, then we should expand our data models to include information on clinical processes outcomes that go way beyond transactional (i.e., administrative claims data) data; the mind-body connection; compliance to and variance from evidence-based guidelines; the efficacy and cost of complementary and alternative treatment approaches; observations of daily living (see http://rwjfblogs.typepad.com/pioneer/2009/04/2nd-round-project-healthdesign- cfp-targets-observations-of-daily-living.html); etc. And these data should be made available to researchers who crunch the numbers and collaborate with clinicians to generate and evolve clinical the guidelines. Furthermore, we need more innovative software programs that deliver cognitive support to clinicians and consumers through use of computational models. In other words, today's data and technology standards, and the conventional crop of HIT tools, are sorely inadequate. Radical innovation is needed for radical healthcare reform/transformation; and I contend that the innovative use of spreadsheets is a key component to realizing this goal. Steve --------------------------- Stephen E. Beller, PhD CEO/President National Health Data Systems, Inc. Wiki: http://wellness.wikispaces.com <http://wellness.wikispaces.com/> Blog: http://curinghealthcare.blogspot.com <http://curinghealthcare.blogspot.com/> Web: http://www.nhds.com <http://www.nhds.com/> From: [email protected] [mailto:[email protected]] On Behalf Of Mark Spohr Sent: Sunday, April 19, 2009 12:17 PM To: [email protected] Cc: [email protected]; [email protected] Subject: Re: [openhealth] Re: I have been invited to testify on 'Meaningful Use' The article seemed to be more about how the EMR/PHR was NOT used, rather thank MIS-used. He kept pointing out that there was information in the EMR which would have improved his care. However, people were not even looking at the EMR. The data model is really irrelevant to the use of data. The user interface and work flow determine how useful the record is. You could store all of your data in a spreadsheet and if it had a good user interface and good work flow access, it would be golden. (Please don't take this as an endorsement of spreadsheets... I am a founding member of a society dedicated to stamping out spreadsheets and people who think they are databases.) .Mark On Sun, Apr 19, 2009 at 5:08 PM, Rod Roark <[email protected] <mailto:rod%40sunsetsystems.com> > wrote: > Interesting article, but I'm not sure its conclusions are on-target. > The data model is more a symptom than an underlying cause of the problem. > > In my view the key point is that we cannot trust the existing > "custodians" of medical IT to get it right. They haven't come close > yet. The only way we'll get there is to require complete transparency > at all levels. And fortunately the new administration does seem to > value transparency. > > And yes, transparency is of course what FOSS is all about. However that > point should not be raised prematurely... but perhaps when responding to > the question of "how do we achieve transparency".... > > Rod > > Scot Silverstein wrote: >> If you get a chance, please touch on "meaningful misuse" as in this story by a software engineer who became a patient: >> >> The Data Model That Nearly Killed Me >> http://www.syleum.com/2009/03/17/healthcare-data-model/ >> >> Scot >> >> -------------------------------- >> Scot M. Silverstein, MD >> Consultant in Medical Informatics >> Teaching faculty in Healthcare Informatics and IT (Sept. 2007-) >> Director, Institute for Healthcare Informatics (2005-7) >> College of Information Science and Technology >> Drexel University >> 3141 Chestnut St. >> Philadelphia, PA 19104-2875 >> >> Email: [email protected] <mailto:scot.silverstein%40ischool.drexel.edu> >> Bio: www.ischool.drexel.edu/faculty/ssilverstein/biography.htm >> Common Examples of HIT difficulty: >> www.ischool.drexel.edu/faculty/ssilverstein/medinfo.htm >> ARS KU3E, member www.arrl.org >> >> [email protected] <mailto:-----openhealth%40yahoogroups.com> wrote: ----- >> >> To: [email protected] <mailto:open-ehealth-collaborative%40googlegroups.com> >> From: fred trotter <[email protected] <mailto:fred.trotter%40gmail.com> > >> Sent by: [email protected] <mailto:openhealth%40yahoogroups.com> >> Date: 04/18/2009 06:05PM >> cc: "[email protected] <mailto:hardhats%40googlegroups.com> " <[email protected] <mailto:hardhats%40googlegroups.com> >, "[email protected] <mailto:openhealth%40yahoogroups.com> " <[email protected] <mailto:openhealth%40yahoogroups.com> > >> Subject: [openhealth] Re: I have been invited to testify on 'Meaningful Use' >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> Sounds good... its got to be short. I do not have much time! >> >> >> -FT >> >> >> On Sat, Apr 18, 2009 at 4:52 PM, Edmund Billings >> >> < >> edmund.billings@ >> medsphere. >> com >>> wrote: >> >>> We should collaborate on a position paper.... I will work some points. >> >> >>> Edmund >> >> >>> ____________ >> ______ >> >>> Edmund Billings MD >> >>> 415.505.8953 >> >> >>> On Apr 18, 2009, at 2:46 PM, "fred trotter" < >> fred.trotter@ >> gmail.com >> >>> wrote: >> >> >> >>>> Hi, >> >>>> It looks like I have been invited to testify in Washington on >> >>>> what it means to have 'Meaningful Use' of EHR systems. >> >> http://www.ncvhs. >> hhs.gov/090428ag >> 2.pdf >> >> >> >>>> As before, I want to ensure that my testimony reflects the >> >>>> attitudes and values of our culture. Using Google moderator for the >> >>>> CCHIT meeting seemed to work. It is even more important this time, >> >>>> because I may be the only voice of reason (the FOSS angle) at this >> >>>> meeting. For this reason: >> >> >> http://moderator. >> appspot.com/ >> #15/e=4a793& >> t=4a795 >> >> >> >> >>>> -- >> >>>> Fred Trotter >> >> http://www.fredtrot >> ter.com > > > ------------------------------------ > > Yahoo! Groups Links > > > > -- Mark Spohr, MD [Non-text portions of this message have been removed]
