Designing an EMRS
Isaac S. Kohane, MD, PhD
Children's Hospital Informatics Program
Designing an EMRS
Usage (as of 3/97)
Existing Infrastructure
CWS Architecture
Design Guidelines
Pediatrics-specific issues
Workflow Results
Clinical Research
Basic Research
Approach Step I
Customers-CWS Answer
Approach Step II
Tasks—CWS Answer
Ethnographic Approach III
Ethnographic Approach—Tables?
Relations—CWS Answer
“The difficult side of medical record systems”
[McDonald et al.]
How Do We Get the Data (pt IV)?
Getting the Data—CWS Answer
Table Descriptions
Table Descriptions (ii)
Table Descriptions (iii)
CWS Client
Patient Selection
Electronic Data Entry: Administrative
Electronic Data Entry: Patient:Provider Relation
How do you get the data in?
Electronic Data Entry: Physical Exam
“Object-oriented” Forms to RDBMS
Electronic Data Entry: Problem Lists
Electronic Data Entry: Medications
Implementation: Paper Data Forms
Implementation: Paper Forms II
Ethnographic Question IV: What is the process of
creating the final document
What is the process of creating the final document?
CWS Answer
Other Text Sources
CWS Data Presentations: Flowsheets
Flowsheets for clinical measurements
CWS Data Presentations: Summaries
CWS Data Presentations: Clinic-Wide View
Clinic-Wide View II
CWS Data Presentations: Text
Results leveraged from open architectured system
Web Access to CWS
CWS Database via Web
Lessons learned I
Lessons Learned II
Acknowledgments