Direct Iteraction Interfaces Columbia University in the City of 直接接口在哥伦比亚大学城.pptVIP

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Direct Iteraction Interfaces Columbia University in the City of 直接接口在哥伦比亚大学城.ppt

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Direct Iteraction Interfaces Columbia University in the City of 直接接口在哥伦比亚大学城

HI6301 - Direct Interaction What is Wrong with EMR? James J. Cimino , M.D., Columbia University Jonathan M. Teich , M.D., Ph.D., Partners Healthcare System Vimla L. Patel , Ph.D., DSc. McGill University Jiajie Zhang , (Organizer), Ph.D., UT Houston What is an ideal EMR? Status of Current EMR Four Perspectives System functions (Cimino) Clinical (Teich) Cognitive (Patel) Human-Computer Interaction (Zhang) System Functions PerspectiveJames Cimino Two Models of EMRs Old Vision New Vision Two Models of the EMR Financial system add-on Repository Financial System Add-On Repository Old Vision Medical record as history Terminology as codes Problems with the Old Vision Cognitive overload Poor coordination of caregivers Computer unable to help with plan New Vision Medical record as Daytimer? Terminology as knowledge base Medical Record as Daytimer? Future is more important than past Goals are stated Alternatives are anticipated Status can be determined Computer can help with planning and timing Terminology as Knowledge Base Coded data become symbols Care plans can be codified Computer can share tasks in the care process Promises of the New Vision Initial status is determined Problems and tasks codified Daily notes are updates to status Progress can be charted Milestones can be anticipated Patient’s distance from desired state can be determined Expert systems can help with state transitions Workflow, scenarios of care, and the EMR Jonathan Teich, MD, PhD November 9, 1999 A little disclaimer What are the Winners? Results review No work required E-mail Immediate benefit Important or requested alerts No work, high importance Non-judgmental, valuable immediate benefit Order sets What are the Losers? Supplying reasons for orders Multiple click sequences Prednisone tapers without support ?EMR’s run into acceptance problems because… They’re not oriented to the scenario Immediate effort Immediate benefit They’re slow “Perfect is the enemy of good” They over-use technology They