By Patricia Flatley Brennan, Director, Project HealthDesign.
I've been in several meetings over the last few days and the
message continues to come LOUD and clear: it's not your old EHR. Single
vendor, shrink-wrapped, fully-integrated electronic health records are slowly
giving way to a health IT ecosystem characterized by apps and more apps,
everywhere. Good or bad, highly distributed information tools, residing
on platforms as different as the smartphone in your pocket to the smartwall in
the ER, are slowly but surely taking over the clinical care environment.
What remains unchanged, however, is the need for clinicians and patients to be
able to trust the tools human life rests on. Clinicians need to know that the
clinical data - lab tests, histories, vital signs - presented to them about a
specific person did indeed originate in that individual. Prescribers need to
know that drug calculations are preformed correctly by the apps offered to do
so. Data from a PHR must be a trustable report of a patient's every day
experience.
Who is responsible for insuring this chain of trust? In the 'old' days of 2009,
the contract between the health IT vendor and the purchasing hospital
incorporated language indemnifying or holding harmless any user of the system.
But now, in this era of apps and platforms, there are many vendors, many
clinical users, and many data sources. Trust is an essential component of
effective clinical information management - how can we preserve the trust while
we diversify the platforms?
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