Rich:
> This is the first BIG ontology based standard that I know of, and in concept
it’s nearly impossible to disagree with.
I’m curious about the kind of standard you’re speaking of here. Although the medical community has a variety of information standards, and HHS/NIST have standards
around Meaningful Use, there is little in the way of true standardization in the market (as you point out later in your post). In fact, outside of the use of certain taxonomies and vocabularies which aren’t all necessarily required to exist in EHRs (CPT,
LOINC, ICD, SNOMED, etc.), there is little in the way of anything approximating an ontology-based standard in EHRs. I have found, in my previous experience, that the benefits you mention (e.g. improved collections, reduced costs) are brought about through
systems that are far from ontological (especially when Meaningful Use Stage 1 requirements were coming into force).
I suppose it’s true that, conceptually, one might see an EHR as representing an ontology, but the structure of that ontology is extremely different from product
to product (vast difference exist even within the product lines of individual companies). The reliance on relational databases is especially problematic. While I can see the benefits of implementing ontologies as the backbone of EHR systems, the reality
is that many of the market leaders are a long way from moving to such a system.
Many medical staff I have spoken with complain about the user experience within their EHRs. I suspect part of the problem is with the fact that many of these
systems *aren’t* using ontologies, and have to be rigidly programmed around relational databases. It would be great to see a push towards rectifying the burdens on end users by implementing ontologies within the EHR market, and providing more standardization
to push interoperability.
David Blevins
Senior Consultant
Booz | Allen | Hamilton
_________________________
308 Sentinel Drive
Annapolis Junction, MD
Booz Allen: 301.419.5962
blevins_david@xxxxxxx
From: ontolog-forum-bounces@xxxxxxxxxxxxxxxx [mailto:ontolog-forum-bounces@xxxxxxxxxxxxxxxx]
On Behalf Of Duane Nickull
Sent: Wednesday, July 16, 2014 7:42 PM
To: [ontolog-forum]
Subject: [External] Re: [ontolog-forum] Survey of Doctors on EHR Ontology Effectiveness
D'oh!! Sorry. This is on by default and I always forget to remove it.
I hereby release all content I have sent to the ONtolog forum under the Open Content license in compliance with the Ontolog Forum IPR policy.
***********************************
Technoracle Advanced Systems Inc.
Consulting and Contracting; Proven Results!
i. Neo4J, PDF, Java, LiveCycle ES, Flex, AIR, CQ5 & Mobile
Duane,
Appreciate your conscious effort to direct proprietary-technology-related conversations off-list. Thanks.
Would be great if you had suppressed the confidentiality clause at the foot of the message as well.
Regards. =ppy
--
On Jul 16, 2014 4:22 PM, "Duane Nickull" <duane@xxxxxxxxxxxxxxxxxxxxxxx> wrote:
Strangely enough, the company I am now working for owns Cientis, the largest HER rating system. For the United States, the website is the AmericanEHR.com. For
lack of a better explanation, Cientis is really the "Consumer Reports" of EHR systems, operating on behalf of many US government agencies and US health care groups.
Unlike MedScape who have only surveyed 20K physicians over 1 year, Cientis has a base of over 750,000 health professionals and has been in continuous use for
surveys since 2010.
I have perused many of the ratings for various HER vendors that comes in through our system and often wondered if the lack of a shared vocabulary for describing
this one aspect of patient care is somehow responsible for the vast disappointment with HER systems by many doctors.
I would be very interested in showing you more of what we are doing and get your input into how the topic of ontologies might help. The US government earmarked
$28 billion for this aspect of health care alone and if improvements can be noted and implemented, it would benefit all American's.
Since Cientis is proprietary and privately owned, I suggest we honour the IPR policy and discuss any details off list (My interpretation was that it is ok to
briefly mention a private system but not okay to discuss the topic in any details on this list).
***********************************
Technoracle Advanced Systems Inc.
Consulting and Contracting; Proven Results!
i. Neo4J, PDF, Java, LiveCycle ES, Flex, AIR, CQ5 & Mobile
EHRs represent an ontology of sorts that has been designed with the best of intentions by the HHS and
other interested medical people. There is a survey of doctors and hospitals on how well the EHR changes are effecting health care in hospitals, physician offices, medical labs and other places.
This is the first BIG ontology based standard that I know of, and in concept it’s nearly impossible to
disagree with. But the EHR is imposing a burden on physicians and lab techs of all kinds; it also produces some benefits. We need to study those benefits and costs if we want to evaluate this ontology task as a prototype of other future tasks we may consider.
This slide:
http://www.medscape.com/features/slideshow/public/ehr2014?src="">
is pretty damning, IMHO, in that it says the cost has mainly been paid in reduced care for the patients.
But there have been benefits for the docs, such as improved collections, integration with their insurance billing, and so on.
The survey as a whole starts at:
http://www.medscape.com/features/slideshow/public/ehr2014?src="">
and contains 35 slides summarizing the surveyed opinions. Unfortunately, the individual contributions
have been nulled out by showing only summary data, so there is no deeper data pool to dive into so far as I am aware. It would be nice to have more descriptive prose from the docs and nurses and techs before limiting the view to just summarized data, as Medscape
has done.
-Rich
Sincerely,
Rich Cooper
EnglishLogicKernel.com
Rich AT EnglishLogicKernel DOT com
9 4 9 \ 5 2 5 - 5 7 1 2
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