Usemed, Arild Faxvaags weblog on healthcare computing

Clinicians need to take back ownership of the medical record

arildf — Thu, 01 Apr 2010 09:34:19 +0000

On the us of electronic medical records to reduce diagnostic errors: Schiff and Bates.

More on Clinical Departmental systems vs. the EPR

arildf — Mon, 27 Jul 2009 11:18:38 +0000

Just to announce a new publication in BMC Medical Informatics and decision-making: Beyond the EPR: Complementary roles of the hospital-wide electronic health record and clinical departmental systems (link). Clinical departmental systems (CDSs) are small EPR like systems that typically are tailored to the clinical needs of one or a few clinical departments. In many hospitals, the management believe that such systems will become superfluous when an institution-wide Electronic patient record (EPR) system is in place. In this project, we explored the many uses of Clinical departmental systems as well as of clinical data resulting from their use. A key to the value of CDSs lies in that they support the generation, storage and re-use of structured clinical data. With such functionality, such systems were superior to the state-of the-art hospital-wide EPR system w.r.t. supporting clinical tasks as well as quality control and research activities at the departments.

Problems with the Veterans Affairs EMR system

arildf — Wed, 04 Mar 2009 05:56:25 +0000

A hospital that implements an IT-system to reduce the occurrence of medical errors might see the opposite effect. More in JAMA.

The wild west of medical imaging

arildf — Mon, 02 Mar 2009 10:23:13 +0000

An interesting read in the New York Times:”More than 95 million high-tech scans are done each year, and medical imaging, including CT, M.R.I. and PET scans, has ballooned into a $100-billion-a-year industry”.

Scope, Completeness, and Accuracy of Drug Information in Wikipedia

arildf — Tue, 27 Jan 2009 00:10:38 +0000

According to this report, information on pharmaceutical drugs on wikipedia is incomplete and much more likely to contain errors of omission compared with the Medscape Drug Reference (MDR). Using http://en.wikipedia.org/wiki/Rifampicin as an example of a Google search result, the authors have compared Wikipedia entries with those of MDR, a “freely accessible general drug information databasethat had been previously evaluated and found to be broad inboth scope and depth of drug information that was gathered from authoritativereferences”. Paradoxically, information on Rifampicin at MDR appear to be unaccessible. Only after having found out that Rifampicin’s trade name is IsonaRif I am able to retrieve some of the the data. Wikipedia may be inferior to MDR with regard to to completeless and acuracy but fares much better when it comes to availability, transparency of the editing process, the use of citations, openess and the extent of linking to other relevant information resources. The collaborative editing of wikipedia entries is an example of distributed human computation. Medicine should start exploring it’s potential rather than warning of its possible side effects.

A case of misuse of Wikipedia information on RxWiki?

arildf — Wed, 14 Jan 2009 21:30:21 +0000

Hmm. The information about Systemic lupus erythematosus on Rxwiki (last updated on 14 August 2007) has strong resemblance to the wikipedia entry on the same topic from 12 August 2007. Is this practice in accordance with the rules for copying wikipedia content? (Wikipedia content can be copied, modified, and redistributed so long as the new version grants the same freedoms to others and acknowledges the authors of the Wikipedia article used (a direct link back to the article is generally thought to satisfy the attribution requirement))

Video on the benefits of electronic care record (NHS)

arildf — Tue, 24 Jun 2008 09:05:43 +0000

A must-see .

Epidemiology of primary care physicians use of EHR systems in the US.

arildf — Tue, 24 Jun 2008 05:41:24 +0000

As of 2007, only one in six US physicians working in ambulatory care have a fully functional EHR system (NEJM). The fact that > 99% of Norwegian ambulatory /primary care physicians (and the numbers in Sweden, Denmark and Holland are almost the same) are using a EHR system might be an illustration of the principle that smaller and less complex organisations are better suited for adapting to new technologies. In Norway, we only have one HMO – the Norwegian goverment. Building and maintaining the component for reimbursement claims is relatively easy. When the EHR system is very good at assisting the physiciains with the numbers, the decision to purchase a system becomes an easy one.

Characteristics of workflow in an innovative vascular surgeon community

arildf — Tue, 24 Jun 2008 05:25:08 +0000

My PhD student Berit Brattheim har recently presented “Clinical Processes in an Innovative Vascular Surgeon Community. Implications for Workflow Modeling” (PDF).

The cost of patients’ uncertainty

arildf — Tue, 11 Mar 2008 17:56:04 +0000

The New York Times: United States ranks 45th in life expectancy, behind Bosnia and Jordan; near last, compared with other developed countries, in infant mortality; and in last place … among major industrialized countries in health-care quality, access and efficiency.

The mixture of anxious patients with physicians authorized to order a battery of medical tests is a very expensive one. Read more.