Comments on: HIStalk Interviews William Hersh, MD http://histalk2.com/2009/08/05/histalk-interviews-william-hersh-md/ Healthcare IT News and Opinion Thu, 09 Feb 2012 04:50:12 +0000 hourly 1 http://wordpress.org/?v=3.3 By: Arthur Gelston, MD http://histalk2.com/2009/08/05/histalk-interviews-william-hersh-md/comment-page-1/#comment-5759 Arthur Gelston, MD Tue, 15 Sep 2009 16:55:00 +0000 http://histalk2.com/2009/08/05/histalk-interviews-william-hersh-md/#comment-5759 I'm not sure if physician admninistrators of EHR/decision support systems need formal I.T training. I think a background in epidemiology would be a plus, but not a requirement. I've been designing production ehr systems for more than a decade, and apart from the physical implementation, in my experience, there is little ongoing role for I.T. in terms of maintenance or content development/evolution. it is unlikely that such a light I.T requirement would be applicable at all vendor installations however. A huge amount of time and energy can be wasted translating clinical I.T functional requirements into terms developers understand, and then QA'ing the delivered product to see that the clinical requirements were delivered properly. Why noy put together a set of high level clinical administrative screens through which the ehr/decision support system is maintained entirely by clinicians, even to the point that their practice comes to comprise electronic system development and support, either within or adjacent to the vendor community? EHR/decision support systems are conceptually much more complex than ADT, inventory and billing systems which were the mainstay of vendor offerings previously, and are properly in the realm of academic medicine, and (some day) a legitimate field of specialization in their own right. In future, I believe EHR will be entirely maintained by clinicians expert in the translation of the logic of the patient record from paper to electronic medium. "I.T" will primarily concern itself with the maintenance of physical infrastructure similar to the way the phone company supplies the infrastructure for telephone service, but doesn't supply the apps on the iphone or blackberry. I.T will become further removed than one might think from the core competencies required to conceive, develop, or run EHR/decision support system in the future. I’m not sure if physician admninistrators of EHR/decision support systems need formal I.T training. I think a background in epidemiology would be a plus, but not a requirement. I’ve been designing production ehr systems for more than a decade, and apart from the physical implementation, in my experience, there is little ongoing role for I.T. in terms of maintenance or content development/evolution. it is unlikely that such a light I.T requirement would be applicable at all vendor installations however.

A huge amount of time and energy can be wasted translating clinical I.T functional requirements into terms developers understand, and then QA’ing the delivered product to see that the clinical requirements were delivered properly. Why noy put together a set of high level clinical administrative screens through which the ehr/decision support system is maintained entirely by clinicians, even to the point that their practice comes to comprise electronic system development and support, either within or adjacent to the vendor community? EHR/decision support systems are conceptually much more complex than ADT, inventory and billing systems which were the mainstay of vendor offerings previously, and are properly in the realm of academic medicine, and (some day) a legitimate field of specialization in their own right. In future, I believe EHR will be entirely maintained by clinicians expert in the translation of the logic of the patient record from paper to electronic medium. “I.T” will primarily concern itself with the maintenance of physical infrastructure similar to the way the phone company supplies the infrastructure for telephone service, but doesn’t supply the apps on the iphone or blackberry. I.T will become further removed than one might think from the core competencies required to conceive, develop, or run EHR/decision support system in the future.

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