Hello all,

This is my first Blog, and my first class in Health Care Informatics. I am learning about this subject from the ground up. After listening to the Health Informatics lectures and reading my text book, I realized that Health Care Informatics Systems has a very close relationship with Information Technology, in both software and hardware.

My background is in software system design, development, user suppport, network engineering and systems administration. Therefore, in this blog, I would like to address some challenges in the Electronic Health Record system from the perspectives of Information Technology that I've leanred from my professional experience.

I have learned that a digital application does not function by itself; many human dedications are involved to make it work the way it should. Because we are human, we make mistakes; and they may become expensive challenges in the life cycle of the application.

The following addreses some of these challenges and perhaps ways to avoid them.

Faulty System Design and Application User-Abondoment:
When an application fails to meet the stake holder's needs, it is not unusual for users to adondon the application. Therefore, it is vital to have a clear understanding of user requirements from the beginning, during the PMP Project Integration Management phase. This is similar to the "Online Consultations," mentioned in professor Yellowlee's text book (Peter Yellowlees, MD, Your Health in the Information Age (2008), p.59). With the exception that data collection, data analysis and project management in the E-Health record system is about the application itself; not the patient.

User Training and Support:
The application has to be developed from the user's perspective: speak the user's language, think like a user, and make it easy for user to utilize it. The support personnel must realize that any questions about the application usage is an important question; bear in mind that it may be this user's first time ever to come in contact with that little weird icon that the support personnel might have explained a hundred time of its usage to other users.

E-Health Record, Real Time Access - Contingency Planning and Recovery:
As the healthcare communicty (doctors, nurses, administrators, and other personnel) begins to enter every bit of patient information, in every stage of the treatment process, into the E-Health record, assuming that paper records will no longer be kept, what would happen to a patient during ER where the system is down due to system malfunction or natural disaster? How could the negative consequences of such a scenario be eliminated or reduced, and at what cost?

Technology does sometime die, no matter how much redundancy and recovery planning have been done. To mitigate the negative impact of such a scenario, do we implement an identical real-time system (a backup system), which run concurrently with this application? At what cost are we willing to invest?

Interface Accuracy
Currently we have paper based and computer based records tha are not linked together (Module I, Webcast lecture.) suppose the E-Health Record application does link these 2 together, what auditing procedure will be put in place, to be followed religiously, to make sure that the records have an absolute accurate link, patient A to patient A, for the entire U.S. population?

In my systems development career, I have worked on countless applications that have misrepresented information (garbage) between application interfaces, such as a customer transaction was posted to the wrong General Ledger ID. In this scenario, it was just a business loss. What if the data mistake contributes to the loss of many human lives?

These are just a few examples of the many challenges that the electronic health record may encounter.

In the quest to understand more about the challenges on the development and support of the electronic health record, I've found the information posted on the HealthIT.hhs.gov website to be extremely informative. On this site, there is useful information on privacy and security, antifraud measures, medical identity theft, federal laws and regualtions, standards and certification, National Health Information Network (NHIN), Health IT Tools, et cetera.

In addition, I have attended an informative Webcast Live Meeting offered via this site to address some questions in providing "Funding opportunity to furnish assistance, defined as education, outreach, and technical assistance, to help providers in their geographic service areas select, successfully implement, and meaningfully use certified EHR technology to improve the quality and value of health care." The total amount of funding opportunity is $598,000,000. You can locate more information about this topic on their website.

Just like the evolution of the Information age and the Internet, I believe that the electronic health record system will become a part of our lives in the near future.

Thank you, class, for your critics. All comments are welcomed.