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At least part of it is that no one has come up with a document format that suits everyone. Doctors want to scribble notes with a stylus but when you digitize th

by flukus 9y ago

At least part of it is that no one has come up with a document format that suits everyone. Doctors want to scribble notes with a stylus but when you digitize that you don't really gain anything, other systems don't know how to interpret those scribbles. Suggesting doctors enter fields into a form instead of scribbling notes will get you no where, doctors are the stupidest and most stubborn smart people you will come across. Not that this is perfect anyway, sometimes you really do just need those random notes that don't really fit anywhere else. Some of the younger ones will type instead of scribble, but it's still mostly free form text and not data. The industry is still stuck on the idea that one doctor visit == one patient record as well, the thought that doctors could input blood pressure readings in their own section and have it display the history as a spreadsheet (or even a graph) has not gained any acceptance. So it's not just about how we transfer information but how it's created as well, we haven't invented the right set of primitives to store it in the first place. I've spent a bit of time thinking about how I'd improve things and think things need to be more like emacs org mode or a jupyter notebook than any current EMRS, but even that might have to wait for a generation of scribblers to die.

vacri 9y ago
From working with a variety of ticketing systems, any veteran dev will be able to tell you just how painful it is to work with multiple fields. Entry is never zippy. The more fields you have, the more painful it is. Most devs, given the choice, will use a ticketing system that is basically free text + a ticket title. If devs, who live and breathe tech, can't comfortably handle the idea of splitting information over various fields (for superior tracking and analysis), why should doctors be any different?
maccard 9y ago
> Suggesting doctors enter fields into a form instead of scribbling notes will get you no where, Maybe in the US, but in the UK and Ireland, all my doctors notes have been typed into a system that is shared among all the doctors in the practice. Last time I went for for an MRI i was given a CD with the mri on it, and I brought it with me to my next appointments. > doctors are the stupidest and most stubborn people you will come across That’s not fair. When I was in university most of the old professors still used overhead projectors and taught the same course from 20 years ago. When I bought my house my solicitor faxed everything, and posted me out the originals of the documents I needed, which took up an entire a4 binder. Developers seem almost bipolar; on one hand you have the “must use shiny new tech” and on the other hand, you have people who won’t update third party libraries ever. We’re still stuck with the same representations of data that we had 40 years ago, and broadly the same basic tools. C and C++ still literally copy and paste header files when including them, all in the name of backwards compatibility. My (long winded) point being, all professions have their own stubborn qualities, and pinning it on old people or a specific profession is wrong

by flukus 9y ago

vacri 9y ago

From working with a variety of ticketing systems, any veteran dev will be able to tell you just how painful it is to work with multiple fields. Entry is never zippy. The more fields you have, the more painful it is. Most devs, given the choice, will use a ticketing system that is basically free text + a ticket title. If devs, who live and breathe tech, can't comfortably handle the idea of splitting information over various fields (for superior tracking and analysis), why should doctors be any different?

maccard 9y ago

> Suggesting doctors enter fields into a form instead of scribbling notes will get you no where, Maybe in the US, but in the UK and Ireland, all my doctors notes have been typed into a system that is shared among all the doctors in the practice. Last time I went for for an MRI i was given a CD with the mri on it, and I brought it with me to my next appointments. > doctors are the stupidest and most stubborn people you will come across That’s not fair. When I was in university most of the old professors still used overhead projectors and taught the same course from 20 years ago. When I bought my house my solicitor faxed everything, and posted me out the originals of the documents I needed, which took up an entire a4 binder. Developers seem almost bipolar; on one hand you have the “must use shiny new tech” and on the other hand, you have people who won’t update third party libraries ever. We’re still stuck with the same representations of data that we had 40 years ago, and broadly the same basic tools. C and C++ still literally copy and paste header files when including them, all in the name of backwards compatibility. My (long winded) point being, all professions have their own stubborn qualities, and pinning it on old people or a specific profession is wrong