Fred Trotter

People talk about EHR, and EMR as though these things always mean the same things. Generally what qualifies as an EHR varies greatly. When you say the word “car” do you include trucks? trucks with 18 wheels? tanks? airplanes when they are on the ground? boats with wheels?

The frustrating thing about both the word “car” and “EHR” is that they can both be used as a “class” of things as well as a specific instance within that larger class.

Technically any “Practice Management System” is an EHR because its on a computer (electric) it has a record of what happened to a patient (health record). Most people specifically do not mean a Practice Management System when they say EHR. CCHIT is one effort to correct this, by creating a set of standards that EHR systems must live up to.

What happens when you specifically define an EHR in terms of functionality? You find out that almost no one has one.

Everyone is talking about the “bad news” that was just released at AHIC. But most industry insiders have know that deep adoption of EHR technology is laughable. What is interesting about the results above is how they defined an EHR, and how reasonable that definition is!

Here are the results.

And the results out of the hospitals surveyed:

The whole point of EHR “Really” Lite was to get the score as high as possible… Even then the usage scores are very poor.

But consider this:

Jha noted in an aside that the percentage of U.S. hospitals with fully implemented EHR systems would double if the Veterans Health Administration at the Veterans Affairs Department were included, because virtually all of the VA hospitals have a comprehensive EHR under the survey standards.

According to this survey, at least, half the hospitals in the country that have comprehensive EHRs, are VA hospitals running VA VistA.

-FT

Reuters is covering the news that Wikipedia is missing critical information about medicines that it covers. Specifically the following results were found:

(researchers) found few factual errors in their evaluation of Wikipedia entries on 80 drugs. But these entries were often missing important information,

and

The researchers compared Wikipedia to Medscape Drug Reference (MDR), a peer-reviewed, free site, by looking for answers to 80 different questions covering eight categories of drug information, for example adverse drug events, dosages, and mechanism of action. While MDR provided answers to 82.5 percent of the questions, Wikipedia could only answer 40 percent.

This is an interesting result. The strength of wikipedia has long been it comprehensiveness. You could find reasonably reliable information there on relatively obscure subjects. The weakness of wikipedia, alternatively, has been its accuracy. So while you might be able to find information on attempts to recreate extinct species, the article might be innacurate in unpredictable ways.

There has been a movement within the wikipedia community to improve the overall quality of the articles. This has resulted in many articles being deleted because they are written in a loose, unreferences style that would have been tolerated in earlier versions of the site.

Apparently, for drug information, the issue is not accuracy, but a lack of comprehensive information.

This has implications for those of us who are intersted in using collaborative, social approaches to Health Information. Depending on what you mean by Health 2.0, this may have important implications for that movement.

Of course, I have to wonder: how do you code around this type of problem?

-FT

My wife attends the University of Houston.

Normally, I reserve this space for discussing Health IT matters, but in this case I must make an exception. UH is one of the most frustrating institutions I know of. I believe, that UH has one of the most ineffective Information Infrastructures I have ever seen. So I am devoting a new topic in my blog to discussing my frustrations with it. My wife (Laura) and I have been having multiple, serious frustrations for some time, and each time I imagine that I should write something about it. But I do not want to start yet another blog, so I am going to use a category of this blog for now.  Perhaps I will use RSS etc to turn this into a separate blog. If you are interested in my Health IT posts… please skip this.

Today vnet.uh.edu is down. Vnet is the portal for students to receive course materials from their professors. Why? As best I can tell, it is down because it is test-time. The university education website is down… when it is needed most. It is probably down because it is being flooded with users. It is being flooded with users since so many students have a test tomorrow.

In short, vnet is exactly the sort of tool that breaks when you need it most.

There is little that vnet does, that Moodle does not do. Moodle, because it runs on Linux, can happily sit in the cloud at Amazon or Rackspace, which means that it can scale (in an automated fashion) to the point that entire countries could hit the website at the same time.

But instead it is being hosted either by the school or by vnet. In either case, it breaks constantly. According to this video vnet “leverages open source”. However, the vnet website has no mention of downloads, community or license. That usually means that the application is 100% proprietary. Further, it is easy enough to conclude that VNET was primarily developed by UH.

I am sure that VNET has some features that Moodle does not. But instead of adding to Moodle, and using a known-good platform, UH has decided to use a platform that they built themselves.

Now my wife cannot get to her documents. And I am sitting here pressing “refresh” in the hopes that I will be able to get onto the site, so that my wife can pass her Genetics class.

-FT