Thanks very much. I found it very useful. Regards Dr. Shinde
--- On Wed, 4/7/10, Tony Shannon <tony.shannon at nhs.net> wrote: > From: Tony Shannon <tony.shannon at nhs.net> > Subject: Re NEJM article: Can Electronic Clinical Documentation Help? > To: "For openEHR clinical discussions" <openehr-clinical at openehr.org> > Date: Wednesday, April 7, 2010, 10:14 AM > For your interest... > > ## > You may be interested in this article just out from the > NEJM. > "Can Electronic Clinical Documentation Help Prevent > Diagnostic Errors?" > http://content.nejm.org/cgi/content/full/362/12/1066?ssource=hcrc > > It contains much thought provoking analysis of the current > challenges in > ? the EHR space. > Its a brief 4 page article that I would recommend to you.. > > Here are some selected excerpts, that are particularly > pertinent as the > ? push for the development of key archetypes > continues.. > > > "EHRs promise multiple benefits, but we believe that one > key selling > point is their potential for preventing, minimizing, or > mitigating > diagnostic errors. Admittedly, evidence to support the > existence of such > a benefit is currently lacking, and our hypothesis runs > counter to the > sentiments and claims of many physicians, who argue that > electronic > documentation in its current incarnation is time-consuming > and can > degrade diagnostic thinking" > > "The problem of having too much information is now > surpassing that of > having too little, and it will become increasingly > difficult to review > all the patient information that is electronically > available." > > "Free-text narrative will often be superior to > point-and-click > boilerplate in accurately capturing a patient's history and > making > assessments, and notes should be designed to include > discussion of > uncertainties." > > "EHR systems should facilitate the documentation of > evolving history and > ongoing assessment." > > "The failure to effectively integrate the creation, > updating, > reorganization, and inactivation of items on problem lists > into the > clinician's workflow has been one of the great failures of > clinical > informatics." > > "Diagnosing illness is one of our most important > professional > responsibilities, and patients justifiably expect us to > perform this > difficult task well. Electronic documentation represents a > pivotal tool > that can help us to fulfill this responsibility. " > > ## > Also of note, see John Halamkas response to this article > that proposes a > ???daily wiki entry for patients in their > EHR, based on each days entry > would have a multidisciplinary entry with one physical > examination, one > assessment, and one plan. > > http://geekdoctor.blogspot.com/2010/04/rethinking-clinical-documentation.html > > ## > > Hope these might be of interest +/- provoke some discussion > & debate on > EHR development and the most effective role of archetypes > at this time... > > Regards, > > > Tony > > > Dr. Tony Shannon > Consultant in Emergency Medicine, Leeds Teaching Hospitals > Clinical Lead for Informatics,? ? Leeds Teaching > Hospitals > Chair, Clinical Review Board, openEHR Foundation > +44.789.988 5068? ? ? ? ? ? > tony.shannon at nhs.net > > ******************************************************************************************************************** > > This message may contain confidential information. If you > are not the intended recipient please inform the > sender that you have received the message in error before > deleting it. > Please do not disclose, copy or distribute information in > this e-mail or take any action in reliance on its contents: > to do so is strictly prohibited and may be unlawful. > > Thank you for your co-operation. > > NHSmail is the secure email and directory service available > for all NHS staff in England and Scotland > NHSmail is approved for exchanging patient data and other > sensitive information with NHSmail and GSI recipients > NHSmail provides an email address for your career in the > NHS and can be accessed anywhere > For more information and to find out how you can switch, > visit www.connectingforhealth.nhs.uk/nhsmail > > ******************************************************************************************************************** > > > _______________________________________________ > openEHR-clinical mailing list > openEHR-clinical at openehr.org > http://lists.chime.ucl.ac.uk/mailman/listinfo/openehr-clinical >
