What is wrong with current Electronic Healthcare Record (EHR) systems?

Current electronic health care systems are leading us on a path to disaster, which is increasingly clear to physicians and nurses working with these systems. So what is really wrong with current EHR systems?

1. Lack of overview of the patient
2. No connection to clinical guidelines
3. No connection between diseases and prescriptions, except very circumstantial
4. No ability to detect contraindications
5. No archiving or demoting of minor or solved problems, things never go away
6. Lack of current status display of the patient, there is only a series of historical observations
7. In most systems, no searchability of any kind
8. An extreme excess of textual data that cannot possibly be read by every doctor at every encounter
9. Rigid, proprietary, and technically inferior interfaces, making extensions with custom functionality very difficult

We need to change the system design process, deployment process, and last but not least, the purchasing process that supports the status-quo of broken EHR systems.

What is the solution?

The solution consists of several parts:

• The introduction of a structural high-level element called “issues”
• The connection of “issues” to clinical guidelines and worksheets
• The support of a modular structure across vendors
• The improvement of quality in specifications and interfaces
• The lessening of dependence on overly large standards
• Lessening of the rigidity of current data storage designs
• The opening of the market to smaller, best-of-breed entrepreneurs

How do we get there?

Getting there is a collaborative project for doctors, hospitals, entrepeneurs and technology developers with a sequence of events that need to take place over time:

1. Raising awareness of the problems and locating interested parties (that is what this blog is all about right now)
2. Identify a market of physicians and healthcare providers that buyin to the problems and will signup for solutions
3. Developing the first minimal software product conforming to the above market needs
4. Evolve the first product, creating interfaces with existing EHR systems
5. Demonstrate the advantages of an alternate “issue-based” approach
6. Invite and support other entrepreneurs to participate
7. Invite dialog with established healthcare IT vendors and buyer organizations
8. Formalize cooperation, establish lean working groups and protocols

Martin Wehlou, CEO

Martin has been a medical doctor and a developer for more than 30 years. He was trained in general and vascular surgery, intensive care, trauma, and general practice. He also holds the CISSP and CSDP certifications. He is the main designer and developer for the iotaMed suite, and is one of the co-founders of the company – see http://mitm.se/

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