Daniel Essin, MA, MD

Real healthcare reform will remain elusive as long as management accepts the notion that the way to fix healthcare is to automate it.

Healthcare - like education - relies heavily on people and as such, can never become the ideal smoothly running machine that many dream of.

When an article on EHR or data makes it into a medical journal, it is most often a speculative picture of the future; basically, it's science fiction.

Welcome to "This Old EHR," where we look at why your system is lot like older homes: built using outdated methods and in constant danger of structural issues.

An unpredictable amount of information in a typical EHR is wrong or meaningless, so it's important for patients to stay on top of their own treatment.

Until narrative and data are united, EHRs will require too much effort, create too much risk, and provide too little benefit to justify imposing them by fiat.

Physicians' reactions to EHR are the same as they were 20 years ago and yet, there may be no going back. But here are some steps to help.

Want to avoid costly EHR mistakes at your medical practice? I proffer the following, which I call the 'Order-of-Magnitude Heuristic.'

EHR is a burden, and as such, there should be evidence of effectiveness before it is imposed upon physicians and medical practices.

To understand why EHRs have the trouble they do, you need to understand the concepts of context and metadata. Here's help.

As big a proponent of technology and data as I am, the truth is data has never cured anything and tech can't replace in-person interactions with physicians.

It's not political or market selfishness that impedes health data interoperability, it's the primitive nature of the technology itself.

Like teenagers trying to imagine what sex will be like, the prevailing wisdom about EHRs reflects optimism more than experience and knowledge.

Lacking validated science, EHR builders, like the builders of medieval cathedrals, use proprietary heuristics to guide them, and achieve inconsistent results.

With healthcare's ever-growing devotion to reliance on the cloud, it's time to rethink our faith and devotion.

After the response – pro and con – to the crackdown on EHR copying and pasting, there is a true solution to capture both narrative and data from physicians.

Look no further than a recent report on copy-paste functions for proof that HHS does not understand EHRs. Here's where they are missing the mark.

It's time for a new paradigm for physicians that focuses on information gathering, not just data gathering.

In the information economy, those practices with good information are rich and have the advantage while those with only data flounder.

Until everything about the EHR changes, demanding that physicians act as data-collection clerks will be unsuccessful.

Creating separate application modules for your EHR delivers optimum results.

The value proposition for an EHR is in the data and its use now, and in the future. Without the data, apps are useless.

Modular EHR designs allow flexibility and other advantages over integrated designs.

EHR, like international relations and war, presents many facets, each of which provides a "box" of sorts that can confine thought in unique ways.

If physicians are going absorb additional patients and regulations of healthcare reform, they'll need their EHRs to provide better tools and impose fewer tasks.

The ideal EHR is highly customizable, but rather than dedicate the time and effort to do this, most practices buy a system pre-configured that causes problems.

There are varying beliefs by those in healthcare when it comes to utilization of EHRs …until something goes wrong with the system.

The NSA has examined communication nationwide in a way that makes it logical to conclude that messages improperly accessed PHI and, therefore, violated HIPAA.

Choosing a bad EHR … is demoralizing and breeds a lack of intellectual honesty and to a loss of respect for quality information

Today's EHRs are not built on a sound foundation and their designs have little grounding in theory, and quakes are coming.