Medical efficacy implies that physicians need to work within the complexity of human biology. They work in the field of adaptive systems. This implies that their efficacy curve has to be functional to deal with low programmed activities. Protocols sustain this essentially low programmed activity.
Paradoxically, there is a widespread perception that EMR/EHR has a low added value for medical practice. This perception hinders the upgrade of medical practice.
But:
1) Is it that EMR and EHR have little added value or is it that they were designed as administrative systems?
2) Is it possible to transform administrative EMR and EHR into adaptive systems with administrative information?
3) How can the misuse of the transparency of the system be avoided?
These are some of the questions that can be solved using an object driven approach to healthcare.
The objects included in the EMR and EHR should emulate the problems physicians need to solve in their minds in medical practice. The basic objects are:
a) Diagnoses
b) Cures
c) Palliatives
d) Patients evolution
e) Prevention
f) Decision making
g) Knowledge bank
Objects driven EMR or EHR are such when they become a necessary part for physicians practice such as a golf stick is for the golfer or a racket is for a tennis player.
There have to be objects for exclusive private use with no access to anyone, such as the decision making alternatives a physician considers, and other objects that can be shared.
Administrative EMR or EHR can only be information reservoirs, legal defendants and control systems. The integration of object driven systems including adaptive objects with administrative functions is the conceptual answer to the problem. Basically, a new concept for interfaces is required.
Changing the interfaces is the first step to enter in the new stage where the computer is a natural part of the physician’s practice.