Explorations in the Design and Implementation of Clinical Information Systems
One of the most difficult aspects of creating clinical systems is rendering clinical concepts in a way that allows computers to reason with them. This is the central challenge in areas such as decision support, workflow management, and interoperability. Building smart EHRs requires computable concepts. Let’s consider a simple example using test orders. Version 1.0 [...]
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Marc Andreessen, of Netscape and Mosaic fame, and current uber venture capitalist, wrote a fascinating essay last year in the Wall Street Journal. In Why Software is Eating the World, he makes the case that software-based companies are gradually assuming a dominant position in the economy. Andreessen offers the following as the basis for this [...]
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Database management systems are central to healthcare information technology. This fact served as a source of frustration in the mid-‘80s when I began creating applications. My first real healthcare application was written in Apple BASIC. It stored information on Swan-Ganz catheter readings. Data were stored using file commands (e.g., READ, WRITE, POSITION)–messy, but it worked. [...]
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It appears I have, unexpectedly, reached a Hamletesque “to be, or not to be” moment with my programming explorations. What began last year as an attempt to learn object-oriented programming and new development tools, segued into tinkering with an idea for PHP/Joomla, and finally morphed into a mini-web development project. As serendipity would have it, [...]
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The desire to understand modern software development best practices is the impetus behind my study of software architecture and design. Fortunately, there are many good books on the topic. Primarily, I have been using: Software Architecture in Practice, Second Edition and Microsoft Application Architecture, Second Edition (1). The former is recommended by the Software Engineering [...]
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As you know, I am on an object-oriented programming (OOP) quest. Most programming languages, and all of the most popular ones, provide object-oriented features. The move to objects in mainstream languages (Smalltalk has never been mainstream) started with C++ (1983) and picked up steam when Java was introduced in 1995. Once Microsoft joined in with [...]
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As someone starting a new software development project, I have a keen interest in ensuring that my product does not create HIPAA headaches for users. Complying with the Security Rule’s technical safeguards seemed like a good start, so I decided to review their implementation specifications while developing security requirements. The technical safeguards are covered in sections 164.312(a)-(e). They [...]
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As I mentioned in the last post, I am making good progress toward learning object-oriented development methods. During the holiday break, I created a small web project to test my understanding so far. The results were encouraging, convincing me to promote my programming activities from a hobby to a real business pursuit. Likewise, mastering the [...]
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Welcome back! I hope you had a wonderful holiday season. Things have certainly gone well for me. I had hoped to spend a week or so planning the next iteration of EHR Science and performing backend maintenance. Well, I managed to do a lot more! Downtime always gets my creative juices flowing, and the last [...]
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The EHR Science Blog presents the musings of Jerome H. Carter, MD, CEO of NTM Informatics, Inc. He is also the editor of Electronic Health Records, Second Edition, published by the American College of Physicians.
Posts on this blog are the personal views of Dr. Carter and do not reflect the official policies or positions of the American College of Physicians.