April 2012

In Case of Disaster, Break Glass

by Jerome Carter on April 30, 2012 · 0 comments

Backups are important. However, when things really go wrong, they alone are not enough.    “Disaster” may sound overly dramatic, but, in fact, catastrophic data losses are not rare.  Depending on where you live, floods, tornados, hurricanes or earthquakes are a fact of life.   Of course, man-made misery (e.g., viruses, tampering, sabotage) accounts for its share […]


Databases à la Carte

by Jerome Carter on April 25, 2012 · 0 comments

Database management systems are central to healthcare information technology.   This fact served as a source of frustration in the mid-‘80s when I began creating applications.    My first real healthcare application was written in Apple BASIC.  It stored information on Swan-Ganz catheter readings.    Data were stored using file commands (e.g., READ, WRITE, POSITION)–messy, but it worked.  […]


Managing Test Results, It’s a Process

by Jerome Carter on April 23, 2012 · 0 comments

Dealing with abnormal test results was one of the main misery points during my years in practice.    It was too easy for things to fall through the cracks.    When clinicians receive an abnormal result, the usual steps are: review the patient’s chart, decide what to do, and take action.  Proper management may require additional tests, […]


For the last few weeks or so, I have taken time from other activities in order to take a fresh look at EHR design. This was not on my to-do list.  It came about because of my interest in how usability, workflow, and other design issues affect implementation success.   EHR implementation is a source of […]


Encryption, an Ounce of Prevention…

by Jerome Carter on April 16, 2012 · 0 comments

Increasingly, data breaches are in the news.  Reports of stolen desktops, lost jump drives, and misplaced laptops seem to show up constantly.   If it seems that you are now hearing more about breaches than in years past, you are correct, and the HITECH Act is probably the major reason. One component of the privacy/security provisions […]


Use and Usability

by Jerome Carter on April 11, 2012 · 0 comments

Since the initiation of the NIST EHR usability program, I have noticed a range of reactions to its supposed intent.  Everything from “the federal government should not dictate EHR design” to “it’s about time someone did something about EHR usability.”  It appears that much of the discrepancy in opinion may be due to the varying […]


EHR Data Accuracy—Should You Be Concerned?

by Jerome Carter on April 9, 2012 · 0 comments

When creating the EHR at UAB, I spent months working on the data model.   Much of that effort went into making sure that the data captured would be suitable for outcomes research.   Of course, the data model can only do so much to ensure data quality–what users choose to enter also plays a role. Anyone […]