EHR Implementation

Well, it has taken longer than expected, but it’s time to discuss Petri nets.   This is the first post in a series that will look at this remarkable tool.  I am enamored with Petri nets because they provide an elegant solution to a range of problems I have encountered during software design and implementation.  Here […]

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Recently, while reviewing visits to EHR Science, I noticed that the number of people accessing the Usability resources page has jumped.   Now that EHR adoption is moving along, usability has gained a much higher profile, both from the ONC as a certification requirement (EHR Certification 2014—Darwinian Implications?) and from users interested in buying systems that […]


Currently, there is a thread on the AMIA Clinical Information Systems Workgroup Group listserv that focuses on the problems/issues encountered during EHR/CIS implementation.   One commentator insightfully pointed out that, over the years, there have been many efforts to understand and alleviate the problems that plague software implementations.   As I have mentioned in previous posts, implementation […]


An EHR Changes Everything…

by Jerome Carter on June 13, 2012 · 0 comments

We are now three years into ARRA/HITECH, and yet implementation tales of woe with unexpected costs and decreased productivity are ever present.    Why? We have RECs, workforce enhancement programs, and more EHR consultants.  Even so, the fact that successful EHR implementation requires significant planning and attention to detail seems not to have sunk in.   It’s […]


Medicare penalties for failure to demonstrate meaningful use are a little more than 30 months away (January 2015).   Considering the time required to select an EHR, implement it, and then demonstrate MU for at least 90 days, time may be getting short for providers who have not already begun the process.   A recent Health Affairs […]


Workflow Analysis–Doing the Math

by Jerome Carter on May 21, 2012 · 2 comments

Workflow-related issues are probably the most challenging aspect of EHR implementation.   First, there is the tedious job of mapping existing practice workflows, followed by figuring out acceptable adaptations to the EHR product’s implicit workflows.    The larger the organization, the longer it takes, and the more people it requires to complete the analysis.   Get it wrong, […]


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, […]