The Infobutton: ONC Gets it Right

The ONC’s proposed rule for Electronic Health Record certification under Stage 2 Meaningful Use includes one requirement that will be good for clinicians and good for patients – the Infobutton.  Under the rule, EHRs certified for Stage 2 would be required to support the HL7 Infobutton standard for two distinct use cases: Providing a context-sensitive link to reference information to support clinical decision making Providing links to patient-specific education resources So what is an Infobutton?  Infobuttons link an EHR to an outside knowledge source.   Importantly, Infobuttons are context sensitive.   For example, if the patient has a diagnosis of multiple sclerosis on his or her problem list, an Infobutton next to that problem would link the user to one or more knowledge sources about multiple sclerosis.  The user can access the information immediately without opening a new application or web page, […]


EHR Saves Lives: Cuts Sepsis Deaths By 25%

“Sepsis is preventable, and at Orlando Health we have set a high priority on infection control as our quality initiative. (Allscripts) Sunrise EHR is an essential part of our initiative to eradicate central line-associated bloodstream infection and catheter-related urinary tract infection. The capabilities of Sunrise significantly help with these efforts.” – Michael L. Cheatham, MD, FACS, FCCM, Director, Surgical Intensive Care Units, Orlando Health Most of us are familiar with sepsis — a serious medical condition caused by an overwhelming immune response to basically a whole body infection. It’s one of the leading causes of death in hospital ICUs. Every year, severe sepsis strikes about 750,000 Americans. Somewhere between 28 and 50 percent of these people die—far more than the number of U.S. deaths from prostate cancer, breast cancer and AIDS combined. MLMs are the key The key to beating sepsis […]

Kenosha Medical Center, United Hospital System

As CMIO of United Hospital System in Wisconsin, I try to make it easy for our physicians to get the information they need to make the best clinical decision. Recently we deployed a Medical Logic Module (MLM) for all 40 of our employed physicians so they can do just that.  Using the MLM, they can view, with one click in their Sunrise Ambulatory EHR, everything they need to manage a patient with chronic disease – and they can do it in less time, with improved accuracy and better outcomes. Before I go on, though, a little history might be in order.  If you’re not familiar with MLMs, you should be.  An MLM is a bit of computer wizardry that’s designed to find all the information within an EHR database pertinent to a single question and alert doctors when the right […]

Do acute care Electronic Health Records always achieve their intended goals? The literature on “unintended consequences” has long warned of the potential downside of EHR implementations and the unique challenges associated with computerization in healthcare settings. Alert fatigue, for example, continues to frustrate clinicians overloaded with un-prioritized pop-ups that lead them to click past both inane and critical alerts.  The moral is that simply computerizing medical records and ordering electronically with CPOE does not lead effortlessly to the clinical, efficiency and organizational performance outcomes we seek. In fact, it often does harm.  I was on the phone recently with a physician friend who was driving home after seeing a patient in a hospital that uses a competitive EHR.  Abruptly he said, “I need to turn around and head back to the hospital – I apparently ordered a ten-fold over dose […]