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In: Data Exchange, Decision Support, EHR Data Quality, EHR Design

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 increasinglyContinue Reading

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In: Clinical Care Systems, Clinical Informatics, Data Exchange, EHR Design, Electronic Health Record Systems

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 haveContinue Reading

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In: Building Clinical Care Systems, Clinical Care Systems, Data Exchange, Discrete Mathematics, EHR Design

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). Continue Reading

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In: Data Exchange, EHR Design, RESTful Data Exchange, Software Architecture/Design, Software Development, Tutorials

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 aContinue Reading

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In: Data Exchange, EHR Design, RESTful Data Exchange, Software Architecture/Design, Software Development, Tutorials

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,Continue Reading

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In: Clinical Workflow Analysis, Data Exchange, Databases, Discrete Mathematics, EHR Design, Petri Nets, Software Architecture/Design

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 anContinue Reading