Thursday, November 21, 2013

Provider EHRs

When I consider this whitepaper from Athena Health, I am struck by the fact that Electronic Health Record (EHR) remains such a vague term with regard to the audience. I can't imagine talking about actual instances of EHRs, as opposed to the generic concept of EHR, without regard to the EHR user. I would say that lumping in solo practicioners, small practices and large practices is a bad idea, an example of the fallacy that "if we solve the most complex case, all other cases will work."

This is especially true for clinical lab orders: every EHR is happy to provide menus for the 20% of the catalogue which makes up 80% of the orders. But there seem to be no EHR vendors who want to support the most esoteric, harder to order labs, let alone properly store and display those complicated results.

Worse, the notion of "lifetime results" is also poorly supported; yes, it is true that some small number of years is as long as most lab results are relevant, but what about those tests whose value never goes away? Those genetic tests which we see repeated over and over again?

Someday I would like to see the following:
  • Acknowledgement that one size does not fit all
  • Full support for lab ordering and resulting
  • Full support for lab consults:
    • if I have a problem with my Amazon order, I can ask about it
    • if I don't understand a lab result, I have no easy way to ask

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