Biomedical Informatics

An Informatics Exploratorium for EHR Design

by Jerome Carter on February 9, 2015 · 3 comments

Experimentation is essential to the development of any new field. In the case of Biomedical informatics, and clinical software in particular, the ability to test ideas in concrete form as functioning software provides a much-needed reality check on expectations and claims. There are many aspects of software systems that must be properly aligned to make […]


Many Theories, No Math…

by Jerome Carter on October 13, 2014 · 0 comments

In my quest to develop a mathematically-based theoretical framework for understanding the relationship between clinical work and clinical systems, I have been reviewing theory-focused articles in the academic informatics literature.   So far, I have waded through socio-technical theory and human factors engineering.   Interestingly, neither uses mathematics to convey their points of view.  Why is this? […]


User Expectations and EHR Design

by Jerome Carter on February 24, 2014 · 2 comments

Ideally, an EHR system should make one more efficient and productive.  Under less-than-ideal circumstances, workarounds, errors and “gotchas” appear and complaints mount.   Addressing EHR design issues requires mapping complaints to specific EHR features and design decisions.  However, mapping is not necessarily a straightforward process.  Some complaints are easily mapped (e.g., the print is too small) […]


Missing data values are always a pain in the neck.   Any measure of data quality and completeness has to contend with missing values.   In production systems such as EHRs that are used during the care process, missing values often occur more frequently than in research databases where quality checks are routinely performed (at least this […]


Moving Beyond Paper-based Thinking in EHR Design

by Jerome Carter on February 11, 2013 · 2 comments

Good software designs help users become more efficient and productive.  Often, determining what constitutes a good design is not straightforward.  While wearing my entrepreneurial hat, I came across a great book that has given me a new perspective on product development and, unexpectedly, EHR design. Thinkertoys, Second Edition, by Michael Michalko, focuses on business creativity […]


EHR selection and implementation, usability, and software design all share a common set of goals, the most important of which are ensuring that users are productive and that patients receive quality care.   Workflow analysis as an adjunct to system selection and implementation is old news (1).  Perhaps, the recent ground swell of interest in usability […]


How I (Actually) Spent My Summer Vacation

by Jerome Carter on August 20, 2012 · 0 comments

In the Gone Fishing post, I alluded to working on a theory of informatics of sorts. Theory may not have been the best term to describe my goal.   Those who have been following the blog have undoubtedly noticed that I am interested in getting at the computational and mathematical aspects of clinical informatics, and by […]