Relational database management systems, and the form of records they
encourage, promote the use of medical record systems for
bean-counting.
Providing the narrative record in format more like that of a
word-processed document encourages its use to support the human
qualities of the clinician.
Aside from the immediate advantage that a system using one or a
small number of files dedicated to each patient rather than
distribiuting each patient's records among all others is
intrinsically a movable patient record (taking with it a viewer if
necessary to support users of other systems), it encourages
programming to support the use of the record in the consultation
rather than its use in administration.
Searching a series of files in order to answer questions about a
large number of patients is achievable, and although it may well be
slower than indexed searches on currently popular databases, there
is no obvious advantage to having a system optimised for searching
if we are to use it as a replacement for the torrent of paper.
Moving to an individual patient file will encourage the evolution of
the EMR as a tool for those actually using in contact with patients
rather than as a tool for those who see it as a means of examining
others' work from the security of their adminsitrative fastness'.
I move.
--- OffRoad 1.9r registered to Adrian Midgley
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