The EHR
Chapter 4 Bedside Questions · 9 questions · about 9 minutes
Organizations bought the EHR as the solution and treat go-live as the destination, so the governance, informatics workforce and executive-physician leadership that actually produce value are never funded. The result is high cost, unmeasured return, vendor dependency, and the same alert, note bloat and dashboard pathology on any platform.
The EHR is an imaging modality (an MRI), not the treatment; without a Diagnostician (the radiologist) it is an enormous, expensive magnet.
Answer as your executive team would, with the evidence in hand. Each question has a factual answer in a system you already own.
Can you state how well your EHR satisfies each of the five indications?
Add a note: where is the evidence, or who owns it?
Who governs the optimization backlog: clinically led, embedded in IT project management, or not happening?
Add a note: where is the evidence, or who owns it?
When was a clinician-driven change request last implemented within 90 days of submission?
Add a note: where is the evidence, or who owns it?
What is your alert override rate, and who is accountable for it?
Add a note: where is the evidence, or who owns it?
What proportion of clinical content has been reviewed for evidence alignment in the last 24 months?
Add a note: where is the evidence, or who owns it?
Have audit logs and dashboard variables been audited against the actual workflow they claim to measure?
Add a note: where is the evidence, or who owns it?
Do you book health IT as a cost to minimize or an instrument to read, and which budget line shows it?
Add a note: where is the evidence, or who owns it?
What has the total EHR run-rate returned in measurable clinical, operational or administrative outcome over 3 years, and who can produce that number?
Add a note: where is the evidence, or who owns it?
Do you treat the EHR as a tool you bought or an imaging modality you read?
Add a note: where is the evidence, or who owns it?
A reflection tool from the book, not a validated diagnostic test or benchmark. Your answers and notes stay in this browser unless you choose to send them. Please don't enter patient information.
A $200 million EHR without a Diagnostician to read it is paying for the magnet and skipping the radiologist.
The Diagnostician, Chapter 4