Clinical Computation

Logic is the foundation of mathematics and, thus required for understanding the rest of the topics in this series of posts.   The most approachable introduction to logic begins with propositions.  A proposition is simply a statement, which is a declarative sentence that is either true or false. Statements Today is Monday. Atlanta is in Georgia. […]


Clinical care is a complex activity, and the systems designed to support it must manage that complexity.   Building systems to assist with patient care requires converting real-world messiness into something computers can manipulate, which comes down to, at some point, 0s and 1s.   Obviously, this is not currently a straightforward process.   The difficulties inherent in […]


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 […]


Wrestling with EHR Data Quality

by Jerome Carter on November 26, 2012 · 1 comment

Ensuring data quality is one of the main challenges faced by clinical database designers. Data quality in clinical applications built specifically for research purposes is protected by safeguards in the form of administrative policies and procedures along with software and database functions.  EHR systems are primarily patient care tools and often lack such safeguards. As […]

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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 […]


An oft-voiced sentiment in HIT discussions is that there is a need for better EHRs.  Few seem to disagree with this sentiment, but, as with many things, creating better EHRs is easier said than done.   After all, vendors are not deliberately trying to create less-than-ideal products.   Rather, I think that anyone who has tried to […]


Making Clinical Concepts Computable

by Jerome Carter on May 16, 2012 · 2 comments

One of the most difficult aspects of creating clinical systems is rendering clinical concepts in a way that allows computers to reason with them.    This is the central challenge in areas such as decision support, workflow management, and interoperability.   Building smart EHRs requires computable concepts. Let’s consider a simple example using test orders.   Version 1.0 […]