Contradictory Observations and Electronic Medical Records

Martin Fowler has an interesting discussion in his ContradictoryObservations post.  This little slice of medically related software design insight is particularly relevant because it highlights (at least for me) the complexity of the use of electronic medical records and their interoperability.

In a broader sense I suppose it also shows some of the underlying difficulties that face the Obama administration’s new EMR adoption push.  But I’m not going there.

The concepts of observationsrejection, and evidence are good, but they’re just the tip of the iceberg:

rejected and evidence

Even after you’ve modeled the data interactions, how do you effectively communicate these concepts to the user?  Or to another EMR that doesn’t know about your model or how it’s used?

Martin’s view is that:

Most of the time, of course, we don’t use complicated schemes like this. We mostly program in a world that we assume is consistent.

Unfortunately, many of the issues facing electronic medical records do require complex solutions. And even when the world is consistent, how you implement a solution may be (actually, will probably be) very different than how I implement it.  Either way, interoperability will always be a challenge.

We’re going to need lots of good software design tools to solve these problems.

4 Responses to “Contradictory Observations and Electronic Medical Records”

  • To accurately support a patient’s medical record, at least four interrelated models are required: a simple static one-level schema is inadequate. The models must support the medical record as a coherent story reconstructed from the sequence of recorded events within the medical record.

  • In order to standardize and make all medical records available to hospital staff, colleagues and officials many health care institutions are computerizing their records and switching to an electronic medical records .Hence we should go for it.

  • Its nice that more and more are dealing with EMR, for it is one of the latest in medical technology. Everything is changing and continuosly progressing, so why not medical recording. EMR or electronic medical records are very helpful nowadays because it is easier to access your medical info. EMR are fast and reliable for they are govern by a physician, in the same way, the consumer controls his or her own health information. EMR is considered to be one of client’s partner in healthcare. This is a very helpful!

  • I am also agreeing with Andy that EMR is a good innovation in medical field its very useful and easy to access. I also search inexpensive EMR services providers on net.

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