On Tue, 5 Oct 2004, Wayne Wilson wrote:
...
> I can't say too many times how important workflow is, technology often
> disrupts workflow or perhaps better phrased, re-organizes workflow.

Wayne,
  I agree completely. All EMR systems impose a specific workflow. Their
ability to support/facilitate modification of their embedded workflow/data
model is typically limited.

> All too often, technologists don't understand what they have wrought and
> spend a lot of time 'dismayed' at the poor uptake of our wonderful new
> technologies.

  I think some are beginning to understand and even trying to take a
different approach. :-) For example:

  We have been doing an OIO-based EMR implementation for a network of
clinics since Jan 2004. I think it should be classified as a semi-custom
application since it contains custom workflows/reports + standard OIO
forms. It looks and feels like a fully-custom application built-to-fit the
specific needs of a specific care-delivery operation. However,
implementation time/labor/risks have been much lower due to use of OIO
components (compared to using other tools/frameworks or modifying existing
EMR).

  To give some background, this is a replacement system for their in-house
developed Coldfusion and Microsoft SQL Server/Access system that became
too expensive to maintain. They were able to use OIO to model aspects of
their existing workflow/data model that they wish to keep. The bonus is
that they can further modify their data model (=OIO forms) and workflows
as their needs change in the future at very low cost (time +
labor-skill-level + risk).

Best regards,

Andrew
---
Andrew P. Ho, M.D.
OIO: Open Infrastructure for Outcomes
www.TxOutcome.Org

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