Dark Brightness

This is a must read article. And confirms my reasoning for keeping my records on paper.

And ignoring the hospital approved forms. The traditional notes work. Read the whole article.

The root of the problem I experienced with health information systems is a very bad data model. Evidence supporting my claim includes these observations:

Incoherent database design isolates patient information from one department to the next and from one organization to the next. This wastes time and increases errors because medical personnel must enter patient information into a unique view of the system that corresponded to user identity and department – this prevents one medical professional from seeing patient information input by another medical professional.

Patient information is easily lost inside the electronic records system

Hard copy patient information becomes dissociated with the electronic record

A healthcare professional’s work pattern is not reflected in either the system design or data model – people spent considerable time searching and data reentry

No master data management MDM in evidence – Production of a consistent record of me as a patient required the ICU nurse to copy data from multiple database views into the in-patient record

Admitted in-patient records are treated differently by the system than out-patient or ER record only patients – no information about my medical history gathered during a prior visit to ER was available to my doctors or nurses.

Nurses and doctors do not have ready access to listings of pharmaceuticals which wasted much time while they searched for information about my daily medications – lists of medications in the system are limited to those at the hospital pharmacy.

No support existed for recording allergies differently than to ambient source and foods – Lists of allergies were not in drop down menus although these are well known by allergists and drug companies.

The root cause of these problems is the failure by information technology IT system architects to correctly capture business requirements. There also is evidence that no one ever produced a reliable conceptual data model. The problem commonly occurs. Too often, system architects simply gather lists of requirements then they ask their favorite vendors to quote a product. This is non-architecture and system non-design. Rarely do architects request information architecture.

Fault also rests with independent software vendors ISVs whose products fail to support end- user requirements – real doctors, nurses, technicians, and pharmacists. Rather they build products to a marketer’s or a developer’s best guess about end-users’ requirements. It is easier to rush a product to market that “looks good” to IT people but horrifies end-users.

via Analysis from the Bottom Up | The Data Model That Nearly Killed Me.