Bad EHR good EHR

See on Scoop.ithealthcare technology

The EHR software we have today is built to document everything you do, but it doesn’t help you one bit to find out what you need to do in the future, and that is what we really need the software to assist us with.

Do you know that the medical records software we use today don’t even have the concept of “disease” in them?

That’s like having accounting software that doesn’t have the concept of “money”. And about as useful.
Typically, a medical record system looks like this, seen from an entity relationship standpoint:



Clearly, the designers must have thought that we doctors are extremely interested in knowing which other doctors the patient has met and exactly when, but this is a huge misunderstanding.

That may be interesting for people arranging cocktail parties, but has very little to do with medicine.

What we do want to know, though, is what ails the patient, that is what health issues he has, so a few of the entities at the top should be related as follows:



 This little change in the basic domain analysis has wide-ranging consequences.


What are the problems?

There are several serious problems, some of which are caused by current Electronic Health Care record systems (EHR) and some which are left unresolved by them.

Lack of overview of the patient

No connection to clinical guidelines, no indication of which guidelines to follow or which have been followed

No connection between prescriptions and diseases, except very circumstantial

No ability to detect and warn for contraindications

Unclear confidentiality borders that make patient privacy difficult to enforce.

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