We want to discuss some of these issues at the upcoming online forum about eHealth and standards on February 25th, 4-8 pm GMT on http://www.talkstandards.com which will raise some of these points and hopefully contribute interesting insight into this fast moving sector.

As you posted a few months ago, have you had any luck in improving efficencies for physicians to avoid discouragement on their part. As I understand their argument, I want them to see the long term benefits and prevent them from discouraging other physicians.

1. Prospective users aren't consulted as to their requirements and the variables in their clinical/administrative environments.
2. “Innovation” and other cleverness takes precedence over (very likely ill-defined) standards, leading to incompatibility between/among components and systems.
3. Users — not developers — need to test the systems in their working environment against measurable standards of performance.

In “Quality is Free”, Mr. Crosby defined the highest quality for piecework and manufacturing as “zero defects” — rework to repair imperfections costs more than assuring those imperfections don't occur to begin with. More importantly for quality in processes and systems, quality's highest measure is always in inverse proportion to the degree of “deviation from requirements”. Ergo, the energy spent to thoroughly and accurately define the requirements is the best ROI for obtaining the desired quality.

And it's the also the greatest guarantee of avoiding “GI” and the inevitably resulting “GO”.

We’ve actually seen the eHR actually add up to 90 minutes to a physician’s day. And no doctor can afford that.

A little bit of time paying attention to how long the doctor actually takes to get into a system, remember 12 passwords and then navigate through a patient record are the key issues most IT Directors doing eHR for the first time tends to miss.