Daniel Essin, MA, MD

There is a vocal group of knowledgeable people that are getting pretty fed up not only with EHR software, but software in general and many are quite vocal.

Here's a simple question for you: Would structured data by any other name smell as sweet?

Simply put, today's EHRs are not designed to collect data in a way that allows accurate meaningful use reports to be created.

There's a new dimension to the knowledge and experience physicians must have to practice effectively and prudently due to the explosion of computer use.

Like patients given antibiotics to hopefully - and immediately - solve a malady, physicians are being told to adopt an EHR as a possible solution to a larger issue.

The file room reinforced the uniqueness of the chart by separating it from the other records kept by healthcare organizations. Few EHRs maintain that separation.

Medical records are not like placing an order on Amazon …but that's exactly how they currently perform.

Yes, there is a difference, and one that may not matter to you today, but you should be aware of for the future.

EHRs need to be embedded in the patient care process, perform specific actions, and get appropriate direction by physicians to truly make a difference.

It seems CMS and I differ in our definitions of quality when it comes to the impact of EHRs on patient care.

Best practices are not best because EHRs present unique requirements that differ qualitatively from those of a generic data-oriented application.

When something is discovered that an EHR should do, but doesn’t, the response is to devise a workaround vs. rebuilding or remodeling the system.

In today's EHR marketplace, Gresham's Law is alive and well, where the bad tends to drive out the good.

Performing a qualitative assessment of your practice's needs is one of the best ways to decide which EHR will provide the best value.

The failure to include medical information science and critical thinking in the medical school curriculum is more a sign of ignorance than of sagacity.

EHR cloud computing is an out of sight, out of mind idea - you won't worry about what you can't see at your medical practice.

Here are some additional thoughts on whether your medical practice's EHR should be located in the cloud or on the ground.

Cloud computing may have advantages but snappy performance is not one of them.

I understand what the government is trying to achieve, but I have to question the "meaningful" part of their EHR Incentive Programs to collect healthcare data.

A new federal health IT initiative may hold the key to greater interoperability and improved sharing of patient information.

What's true for security is true for interoperability -it cannot be added on, it must be designed in. That means current EHRs need to be redesigned from scratch.

Don't tell me you want interoperability - that's meaningless. Tell me what healthcare data you need to send or receive, where and how often.

EHR construction is analogous to house construction in many ways, but the builders of both structures may not always have the right tools for the job.

A colleague of mine has a high-end EHR, but I think my clinic's non-EHR system does everything I need with fewer headaches.

What would Dwight Eisenhower say about today's healthcare environment? Wonder no more.

Much like our patients, why do physicians balk at changing behavior given all the risks and possible bad outcomes of using an EHR?

Many of the operational characteristics that are common in today's EHRs encourage dishonest behavior and create a vicious cycle.

If people are willing to download games to their personal devices, why not create home healthcare monitoring systems for the same ease-of-use?

From e-books to your EHR-based data, how long do computer-stored files actually "exist"?

Computer science researchers have learned much that has yet to find its way into the techniques and tools used to develop the software that you use - like your EHR.