[Gnumed-devel] address@hidden: Re NEJM article: Can Electronic Clinical Documentation Help?]

[Karsten Hilbert]

FYI:

----- Forwarded message from Tony Shannon <address@hidden> -----

> User-Agent: Thunderbird 2.0.0.24 (Windows/20100228)
> Subject: Re NEJM article: Can Electronic Clinical Documentation Help?
> 
> 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            address@hidden
> 
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