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January 31, 2008
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Your main New Year's resolution is to:

  • Work harder/smarter and get promoted/a raise 25.00%

  • Spend more time with your family, improve personal relationships 15.00%

  • Become more involved with your religion, develop spiritually 5.00%

  • Lose weight, get into better shape 40.00%

  • Nothing specific – everything's on the right track 15.00%

Considering where the industry is with respect to standards and integration, do you favor:

  • Best-of-breed solutions that require smaller upfront costs, but then need to be integrated. 24.00%

  • Enterprise solutions that require larger initial investments, with fewer integration costs down the road. 24.00%

  • A mix of the two — having multiple products from one vendor, with other solutions thrown in. 52.00%

    Should the government mandate e-prescribing?

  • Yes, now. 31.50%

  • Yes. But not for at least one year. 21.26%

  • No. The industry is nowhere near ready and may never be. 8.66%

  • No. It's not the government's place to mandate such things. Let market forces dictate adoption. 38.58%


Dear Daphne:

I read your article in the December 2007 issue of Healthcare Informatics titled “Next Generation EDIS” and we all acknowledge, as stated, that the Emergency Department is a key player in the continuum of care. It is precisely that reason however that makes an integrated product the only viable long-term solution.

Can a third-party EDIS be interfaced to an integrated HIS, such as MEDITECH? Absolutely, but at what cost? It would have been worthwhile for you to ask ECHN how much they spent for the Allscripts product, the Iatrics interface, and the internal and external staff to implement it. How about the additional training cost for those that have to learn a different environment? Also, how many staff are committed on an ongoing basis in the department and IS (e.g., Help Desk) to support the interfaced environment? Also ask if they've calculated the time and effort (and expense?) needed for each upgrade cycle for either or both products to retest all those interfaces.

Lastly, as the industry moves toward CPOE, real-time clinical decision support, and evidence-based protocols using data-level triggers and a common medical vocabulary across multiple applications, will these interfaces suffice? Everything I read in the IT trade journals says to simplify the computing environment for users and technical staff to improve efficiency, productivity and agility. Interfacing a third-party EDIS doesn't seem consistent with that direction.

Vincent S. Vitali

Interim CIO

BroMenn Healthcare

Bloomington, Ill.

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