Healthy Living Dealing Amongst Ehr Dissatisfaction (Part 3)

This post is a continuation; Part 1 is at this link. In this post, I speak over what's needed to brand EHRs to a greater extent than satisfactory too reply questions most my claims.

I wrote:

What’s needed is a paradigm-busting shift inwards which clinicians too software developers collaborate to exercise tools that are genuinely clinically useful too promote (rather than destroy) efficiency. We tin get-go past times redefining Meaningful Use – run across my weblog post at /search?q=dealing-with-ehr-dissatisfaction-part-1

I too thus answered a query most my claim that over-reliance on XML too Web services is a big work amongst HIT standards:

I'm non maxim that XML can't work; only that XML is beingness over-used. When information sets are rather uncomplicated or XML is used for sending messaging functioning instructions for spider web service, I select no work amongst it. But when it comes to representing complex data, every bit inwards a CDA-based document or a complex shape Definition file, XML sucks!  

Here’s why: When yous exercise XML inwards such cases: human readability is a joke, verbosity is huge, too parsing requirements too complexities are immense. It also forces conceptual incongruities only to popular off on information inwards hierarchies when such parent-child relationships are unnecessary. See /search?q=dealing-with-ehr-dissatisfaction-part-1 too /search?q=dealing-with-ehr-dissatisfaction-part-1).

I fought against this "let's exercise XML for everything" mentality since the mid-90's, but to no avail. Now the crap is hitting the fan!  

Bottom trace of piece of work is that at that spot are much easier/simpler too to a greater extent than rational ways to stand upward for complex information than XML, fifty-fifty hierarchical data. We've got to get-go busting maladaptive paradigms.

Regarding the spider web services issue, I select no work amongst this architecture for the most part, but bringing SOAP too RESTful into the DIRECT Project, too relying on them alone inwards other Federal initiatives, adds similarly increased complexity, every bit good every bit vulnerability, every bit I speak over at /search?q=dealing-with-ehr-dissatisfaction-part-1.

What nosotros involve is a hybrid approaches that balances spider web services too XML amongst simpler elegant methodologies.

These issues came to a caput during the standards-making procedure at the S&I Framework Structured Data Capture (SDC) first where I fought for the inclusion of a much simpler approach to capturing information using electronic forms, but was voted downward past times the community (see http://wiki.siframework.org/Canddiate+Standards+List+Feedback). To their credit, however, they are allowing our squad to pursue a airplane pilot (on our ain dime) fifty-fifty though it volition demonstrate exercise of technology/methods that aren’t fully compliant amongst the implementation remove they are developing.

In whatever case, the sort of alter nosotros involve isn't going to occur past times EHR manufacture lobbyists or the Feds ... As I said before, it's got to endure led past times clinicians too researchers working closely amongst creative software developers (including nimble EHR/HIT vendors) who focus on designing too deploying clinical tools that are genuinely useful too useable.

In purpose four at this link, I speak over a practical vision of a next-generation EHR organisation that tin endure built today, which addresses the many criticisms of what is happening today.

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