Data Exchange

A Summer of EHR Design Questions…

by Jerome Carter on May 23, 2016 · 0 comments

As always, I am looking forward to the slow, languid days of summer when things quiet down and the mind can wonder (wandering is fine too). Typically, I have a book list to get through. A few summers ago, math was the focus. Once it was software architecture; however, this summer there are no books, […]


Current EHR and HIT thinking places significant value on immediate and downstream use of EHR data.   The expected benefits of interoperability, clinical decision support, and data analytics all depend on accurate EHR data.  Yet, somehow, data quality has not gotten the attention that it should.   While clinical researchers are increasingly focused on improving phenotyping algorithms […]


What is the Smallest Viable Unit of Clinical Data?

by Jerome Carter on April 13, 2015 · 4 comments

In trying to free myself from past assumptions about clinical information system design, I decided it was a good idea to question everything. Like everyone else, my view of electronic systems has been colored by the use of paper charts. Shaking off preconceptions is hard. In doing so, I have found it helpful to look […]


We gain understanding by asking good questions.  Questions about even the most common, mundane things can yield wisdom and point the way to important discoveries.   According to William Stukeley, Isaac Newton began his research into gravity because he wondered why apples always fell down and never sideways or up (1).  How many people had seen […]

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Ultimately, REST is about accessing resources.  Efficient and effective use of resources requires that all components make use of a uniform interface for all interactions.   Roy Fielding lists four constraints that interfaces must follow in order to meet REST specifications. Constraint Identification of Resources All resources must have a unique ID (e.g., URL) Access […]


EHR Systems are complex entities, and that complexity has downstream effects that are increasingly noticeable in the form of user complaints.   EHR system complexity is a direct result of having to address so many competing requirements.  We expect a lot of EHR systems.  We expect them to meet domain-specific requirements–HIPAA, MU, legal record, workflow, decision […]


Greatest Hits: Volume 4

by Jerome Carter on June 3, 2013 · 0 comments

As the motto implies, EHR Science is about the design and implementation of clinical systems.    Over the past two years, my personal explorations in architecture/design, discrete math, workflow and software development tools have lead me to search for underlying principles and precepts that could make EHR design less of an art and EHR implementation less […]