On Fri, 2004-10-01 at 16:40, Daniel L. Johnson wrote:
> Dear All,
> 
> First of all, this is not an announcement; this is merely conversation,
> because Gunther Schadow does not want to make any announcements "until
> there is something to announce." ...

I'm replying in a batch here...
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On Fri, 2004-10-01 at 16:54, Joseph Dal Molin wrote:
> Dan...what will be context...primary care/clinics or acute care??

I'm not aware of a difference; Martha and I are primary care clinicians
who, I think, include both acute and chronic care visits.  It is not, as
far as I know, initially aimed at the emergency department or the
"doc-in-a-box" urgent care setting.
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On Fri, 2004-10-01 at 17:10, Calle Hedberg wrote:
>  you mention that
> 
>>Studies have shown approximately a 20-30% loss of physician efficiency
>>during visits with the use of EHR software
> 
> Can you provide any direct references (or even better, URLs) to such
studies?

I am guilty of perpetuating what I've heard at meetings, and haven't
scrutinized the literature personally.  This was my recollection from
sessions on EHR in March at the AHQA (American Health Quality
Association) meeting.  One presentation in particular, by an urgent care
physician/medical manager, Dr. Jane Brock, was a eloquent survey of the
personal and institutional frustrations of EHR use that resulted in 2
proposals of marriage from (male) physicians in the audience.

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On Fri, 2004-10-01 at 18:13, Andrew Ho wrote:
> On Fri, 1 Oct 2004, Daniel L. Johnson wrote:
>> 1: to test the utility of the new FDA-mandated computerized "package
>> insert" (Dr. Schadow was an FDA consultant in its design).
> 
> Do you know how these package inserts from FDA's "electronic labeling"
>(http://www.fda.gov/bbs/topics/NEWS/2003/NEW00991.html) requirement
> will be published? 

I do not.  Gunther told me last month, if I recall correctly, that these
have not been finalized.

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On Sat, 2004-10-02 at 00:06, Tracy Bost wrote:
> As part of the design process, what tier, framework,
> technology,etc will be used?

I have been remaining willfully ignorant of the technical plans.  You
have driven me back to the grant proposal, which says,

"The prescribing tool will be built entirely based on standards and open
source components and programmed in Java for maximum portability....
structured according to the HL7 [RIM]... [its] implementation of the HL7
RIM and HL7 data types in Java under the... Java SIG... will be the
basis of the data architecture for this... project.

"The Java SIG objects will be persisted in an...[RDBMS] using the
Hibernate object relational broker system.... The...mapping will be ...
generated from the HL7 RIM meta-data.... The common [rdbs] will be
PostgrSQL.

"The system will be client-server based and initially...web-browser
based....

"For the server engine...a Servlet capable Java-based web-server suchas
Jakarta Tomcat...[using] SML...XSLT... [staying] away from complex
application server architectures in order to focus...on a reusable
infrastructure...that is not loced into a certain architectural system
model like J2EE, CORBA, etc."
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Hope this helps satisfy curiosity.

Dan Johnson

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