Dan:
You wrote "Studies have shown approximately a 20-30% loss of physician
efficiency
during visits with the use of EHR software". Any links handy?


David D Derauf MD MPH
Executive Director
Kokua Kalihi Valley

 -----Original Message-----
From:   Daniel L. Johnson [mailto:[EMAIL PROTECTED]
Sent:   Friday, October 01, 2004 11:41 AM
To:     OpenHealth List
Subject:        physician prescribing tool development

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 am conversing with this list simply because I thought you would all be
encouraged to know that the US Agency for Healthcare Research and
Quality has awarded a grant to Indiana University-Purdue University at
Indianapolis for development of an open-source computerized physician
order entry system, to be led by Gunther Schadow, MD, of the Regenstrief
Institute.  Dr. Martha Adams of Duke University and myself have
volunteered to test the implementation of this software.

Design begins now; implementation is to begin in about a year.

The plan is to develop a software tool that will provide "decision
support" for physician e-prescribing.  This tool will live on a Linux
server and be accessed by users through a browser.

The formal goals of this project are:
1: to test the utility of the new FDA-mandated computerized "package
insert" (Dr. Schadow was an FDA consultant in its design).
2: to use HL7 v3 tools to deliver decision support to
prescribing: default dosing, dosing correction for height, weight, and
renal function, dose checks, contraindication checking, allergy
checking, and drug-interaction and food-drug interaction checking.
3: to evaluate whether physician efficiency is gained by its use.
Studies have shown approximately a 20-30% loss of physician efficiency
during visits with the use of EHR software; a design goal of this
project is to have the opposite effect.  A time-motion study of
physician work during office visits is an important feature of this
project.
4: Medication errors are the leading cause of adverse medical events.
About half of these occur in prescribing: approximately half of these
involve dosage or frequency errors, half involve prescribing against
contraindications or known interactions or allergy.  This tool will be
designed to specifically remediate these errors, estimating that it
could reduce about 2/3 of prescribing errors.
5: The goal is to have a fully functional tool available for deployment
and use beginning October, 2006.
6: Gunther is aiming at making this open source.  He is interested in
collaborative development, but of course must balance the need to stay
on track with the grant timeline against the ideal of distributed
development.  I will of course encourage him to allow collaboration in
development, but for now he's hunkered down in full Project Organization
Mode.

To repeat: This is *not* an announcement.  If there were "something to
announce" it could be an announcement, but as there is now no meat on
the barbecue, no one is currently invited to dine.

Best wishes,

Dan Johnson md
Menomonie, WI


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