Ian Haywood wrote:
> On Thursday 15 February 2007 08:12, Elizabeth Dodd wrote:
>> On Wednesday 14 February 2007 23:41, john hilton wrote:
>>> How would you like a surgerywhere in each GP's office the doctor uses his
>>> fave EHR frontend prog, from a shared db?
>> That's what I was thinking of when Horst made his suggestion. I'd love it.
>> I would never be blamed because of my choice of program (although I haven't
>> had any for more than a year)
> 
> One of the things I've learnt from trying to write an EHR is that the GUI and 
> the backend are inevitably wedded fairly closely in term of behaviour. You 
> can move things around, change fonts, colour etc. very easily, but to 
> implement a particular workflow on the GUI, you need a matching database 
> structure.

Yes, exactly right. It is not so hard to generate generic interfaces
from a back-end schema, but it is all the bells-and-whistles, the little
conveniences and shortcuts that turn an application from clunkily
painful into usable.

> This is also why a 'common set of fields' to make EHR data portable is very 
> hard, unless you make it very simple, and then the imported data won't be 
> as 'rich' as the EHRs own data. For example, you won't be able to do 
> automatic repeats scripts from the old data, as it's just a free 
> string "Amoxil 500mg tabs" which the new EHR can't make sense of. You can 
> read it though, so it's still useful.
>  
> This is not absolute, I think it is possible to have the two interfaces 
> demonstrated by Richard and Horst talk to the same backend, (and an MD-style 
> one as 'lowest comon denominator') however it would need very careful 
> thought, and there would be limits, certain areas were all the clients would 
> have the same or similar behaviour.

The OpenEHR guys are trying to develop shared, interoperable data
storage/retrieval as well as automatically generated template driven
front-ends for those back-ends. We've yet to see the back-end bits fully
working, although they are said to, but I am very dubious about their
ability to generate rich, user-friendly front-ends, automatically (or
semi-automatically). at some stage, things need to be customised to suit
the particular database schema and workflow in use.

Tim C

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