As everyone who has switched from paper to electronic charting and ordering has witnessed, despite some improvements, many processes became greatly more inefficient. And – it doesn’t matter which Emergency Department information system you use. Each vendor has its own special liabilities. Standalone vendors have interoperability issues. Integrated systems appear to have been designed as an afterthought to the inpatient system. We have, begrudgingly, learned to tolerate our new electronic masters.
This study, in Annals of Emergency Medicine, describes the efforts of three authors to design an alternative to one of the vendor systems: Cerner’s FirstNet product. I have used this product. I feel their pain. And, I am in no way surprised these authors are able to design alternative, custom workflows that are faster (as measured in seconds) and more efficient (as measured in clicks) for their prototype system. It is, essentially, a straw man comparator – as any thoughtful, user-centric, iterative design process could improve upon the current state of most EDIS.
With the outcome never in doubt, the results demonstrated are fundamentally unremarkable and of little scientific value. And, it finally all makes sense as the recurrent same sad refrain rears its ugly head in the conflict-of-interest declaration:
Dr. Patrick and Mr. Besiso are employees of iCIMS, which is marketing the methodology described in this article.
Cheers to Annals for enabling these authors to use the pages of this journal as a vehicle to sell their consulting service.
“Efficiency Achievements From a User-Developed Real-Time Modifiable Clinical Information System”
http://www.ncbi.nlm.nih.gov/pubmed/24997563