Simple thing really - doctors using EMR systems, doctors doing doctoring.I think this is a key statement and probably should be considered for inclusion in major EHR requirements works like the ISO 18308 TS.
80% of what we do we do simply, easily and quickly, and are communicating through the notes with others who know it was simple, quick and easy.
But much of the model of what we do is about the other 20% - where we work from gathering information, forming and then testing a series of hypotheses and using external information to determine the currently best treatment based on evidence where available.
Usability and acceptability demands that the work done on making the 20% safer and better and even arguably quicker does not slow down the 80% to the same rate.
Adrian, I've come to suspect the same thing by my conversations with doctors about how they work. I am interested to know if you really think 2 modes would make sense, even if they are secretly chosen by the software. Would you characterise the 2 modes as:
I suspect that it may even justify having two modes, but it would be nice if the system ran in one mode but spotted the point of change.
- "simple patient" / "complex patient" (e.g. based on consult time, nr consultations)
- "simple problem" / "complex problems" (e..g based on number of comorbidities)
- "simple treatment" / "complex treatment" (e.g. advanced diabetic versus child's ear infection)
could the software try and guess what kind of patient you have based on number of consults & consult time? Or would more sophisticated queries be needed? Another way might be to configure a system to detect all patients of particular pre-specified profiles.
What would the two modes look like in terms of user interface & workflow?
- thomas
