No, I’m not talking about a system error message like Windows’ infamous “Abort, Retry, Fail?” I’m talking about active cognitive ignoring. This occurred to me as I’ve been using an electronic medical record system called DocuTAP. It has many very, very busy screens, each with a hundred or so items from which to choose. But [...]
An experimental study recently (late 2011) ballyhooed in the press looks at how we tend to forget things as we move into a doorway, and that walking back into the room doesn’t help you recover the memories. (Duh. I could have told anyone this. As could everyone.) Not sure why prior studies on the same [...]
The Whorf-Sapir hypothesis says that our language shapes how we think. It’s been moderately debunked in recent decades, but it’s likely true, at least in small part. And one of those small parts is when someone coins a new word that encapsulates a new idea. There has been a debate within philosophy since Plato’s time [...]
“This job would be great if I didn’t have to chart.” Physicians say this all the time. One way to not have to chart (much) is to work with a Federal Disaster Medical Assistance Team (DMAT) team. Although the National Disaster Medical System now has an electronic medical record (EMR) system, it used to just [...]
Speaking of “Bad Design Killing” a big part of the discussion at the ACEP Informatics Section meeting in San Francisco this month was about one particular usability problem with CPOE: entering orders on the wrong patient. I’ve done this myself – as far as I know I’ve always caught it before anything bad occurred. Many [...]
The Pennsylvania Chapter of the American College of Emergency Physicians (ACEP) held an international symposium on ED computer systems, November 12-15 in Miami. This was the fifteenth year for the conference. The focus was on how to effectively and efficiently use computer technology for ED process improvement. There were attendees from the 6000-bed Chang Gung Memorial Hospital in Taipei, and from the UK. Reviews from the attendees and from the vendors seemed quite positive. In 2009, there was no conference due to the worldwide recession. The 2010 conference’s attendance was below projections. There are various theories as to why this was so: the continued economic slump, the transition in many hospitals to being forced to use the ED module of an enterprise system rather than a niche system, and others. Regardless, PaACEP has determined not to offer this conference in the future.
There are many websites and blogs devoted to emergency medicine, and to medical informatics. There are a few devoted to emergency informatics. One of the oldest and most well-respected is ncemi.org, founded by Dr. Craig Feied and friends. Craig is longtime member of the Informatics Section of the American College of Emergency Physicians, formerly of the George Washington University Department of Emergency Medicine, the Emergency Department at the Washington Hospital Center, and now at Microsoft.
A well-respected and very easy-to-use set of medical calculators (slanted to the ED) is available at mdcalc.com. Graham Walker set this up when was a third-year medical student and continued to upgrade and expanded it while an emergency medicine resident at St. Luke’s-Roosevelt Hospital Center in New York City. A consortium of emergency medicine residents and attendings affiliated with St. Luke’s-Roosevelt Hospital Center have also developed a companion website, an extremely user-friendly front-end to the evidence-based practice of medicine called thennt.com. (NNT is the “number needed to treat” and is a useful measure of how many people you have to treat to have a good effect on one person.)
The Emergency Informatics Association was founded a few years ago. It’s an association of both academics and vendors deeply involved in the nuts and bolts of emergency department informatics.
KLAS is a consulting company that studies healthcare IT in general. They do review and provide a bit of information on their website for free, but most of the opinion-poll information they gather, which is quite extensive, is available in reports costing $5-10,000. I have heard from a usually reliable source that some of the companies that big HIS vendors they review (examples of big HIS vendors include Epic, Meditech, Cerner) have contracts such that no employee of the hospital is allowed to say anything negative about their product. If true – and given the past conduct of HIS vendors, as reported at the EDIS over the past fifteen years, it seems likely – this makes ratings of such HIS vendors suspect. Recent gains in the rating of HIS vendor’s ED modules compared to the “best of breed” do, however, to some degree reflect a genuine improvement of the HIS ED modules in general.
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