Zowie! Tweets of the Week for January 31, 2010: Ponies, Pediatric EMRs, Productivity, Plugins, and Paper

Question: Are Healthcare Institutions Using Business Process Management Software with Fiscal and EHR/EMR Software? My Answer…

Short Link: http://j.mp/7BUeai

I “data mined” my Twitter “thought stream” this weekend and reminded myself of an interesting question on the Six Sigma & Process Improvement website.

Question:

“In the Healthcare environment, are there institutions using BPM software platforms in conjunction with ERP (fiscal) and EHR (medical) platforms?”

(BPM stands for Business Process Management, a frequent topic on this blog.)

Since no one answered it, I nominated myself.

You can see my posted response at:

http://www.sixsigmaiq.com/Question.cfm?externalID=1647 (Short Link: http://j.mp/6b3AlQ )

But below is a more readably formatted version.

My answer:

What a great question! EMR/EHRs, workflow systems, BPM, and financial applications are converging and we (patients, physicians, solution developers) should all be glad they are finally doing so.

Process-aware technologies such as workflow management systems and business process management suites have matured and proven their worth in various industries. They will diffuse throughout healthcare. At the same time, traditional (that is, non-process-aware) electronic medical/health records (EMR/EHR) are coming under increased critical scrutiny. Many EHR implementations fail, estimates range from 30 to 70 percent. Government efforts to increase EHRs adoption by physicians paradoxically have had the opposite effect. A big part of the problem is that physicians realize that traditional EHR workflow is one-size-fits-all, and therefore does not fit them. In response, a growing number of EHR professionals are beginning to realize that physicians are not the problem; it is lack of usable and flexible EHR workflow.

EMR/EHR productivity, usability, and workflow issues are effectively blocking adoption of a technology, which if it were to be adopted, would greatly improve (1) our knowledge of what works and what doesn’t (clinical outcomes research), (2) coordination of care between clinicians and clinicians and between clinicians and patients (interoperability), (3) real-time monitoring of patient care (alerts, reminders, compliance with care plans), and (4) means to systematically improve medical care effectiveness, efficiency, and patient and physician satisfaction.

EMR/EHR productivity, usability, and workflow issues are inextricably intertwined, a Gordian knot of interdependencies. Process-aware technologies such as workflow engines, process definitions, and business process management techniques are promising ways to manage these interdependencies.

Non-process-aware EHRs are difficult to optimize in a business process management sense. Their workflows and processes are too highly constrained by design and implementation decisions made by traditional programmers using third generation computer languages. A physician should not have to rely on a C# or Java programmer to tweak his or her workflow. Lack of easily changeable workflow/process definitions at points of care, and points between, makes systematic improving clinical workflow difficult, slow, and expensive.

EMR/EHRs built on workflow management system/business process management suite foundations are the next logical evolutionary step of EHR technology. They are essentially a new class of clinical information systems, existing at the intersection between two great software industries: electronic medical/health record systems and process-aware workflow management systems/business process management systems. The hybrid EMR workflow systems that will result will be more usable and more systematically optimizable than traditional EMRs with respect to user and patient satisfaction, clinical performance, and hospital and medical practice financial viability.

That’s the vision, at least. The reality is that I am aware of one well-known EHR workflow management system/business process management suite on the hospital side and one such system on the ambulatory, medical office side. I am also aware of a number of document imaging/scanning workflow systems used by healthcare payers and in non-clinical hospital departments; however I don’t “track” them. Without structured syntax and semantics of patient-specific data, the following important activities will not be possible: clinical outcomes research, institution-to-institution coordination of care, real-time patient care activity monitoring, and the process mining that will be necessary to improve the these activities.

Fortunately, I am seeing an uptick in interest by healthcare organizations and health information technology vendors in process-ware/workflow management system/business process management approaches to problems that traditional EMRs have failed to solve. This interest is evinced in trade publication articles about the potential for BPM in healthcare, press releases about new initiatives to use a BPM system in a healthcare venue, blog posts and comments (see below), occasional job announcements, and excellent questions such as yours.

For example, the following is a randomly picked blog comment (not my blog or comment, see http://j.mp/5R9N3s, written by someone familiar WfM/BPM but directed toward the physician blog author):

“Most existing EMR systems are a combination of data collection and storage (the facts) and the workflows associated with these facts (e.g. the follow-ups, ticklers. Etc.) The facts can be standardized but the workflows vary from practice to practice and physician to physician….Most existing EMRs handle workflow as if every physician/practice were identical…There is a whole separate class of software products with names like workflow management or business process management which is focused on how facts flow between people and what happens when flows are interrupted…Once you’ve seen a general workflow system in action you never want to go back.”

You also mentioned integration of fiscal applications into the EMR/EHR BPM mix. As great a picture as I have painted, the picture that results when you add financial data is even more extraordinary. I used to work in a hospital MIS department (wow! when I think about that potential!). However for the last decade I’ve worked in the primary care industry, specifically in pediatric and primary care. So in my following comments about combining clinical cost and clinical workflow data I will stick to what I know. However, I think you can extrapolate to other specialties and institutional venues.

One of the great promises of EHR workflow management systems in general, and primary care EMR workflow systems in particular, is the pairing of activity-based costs with process definitions. Since each step in a patient encounter process definition is time stamped as to when it is available to be accomplished, when it starts to be accomplished, and when it is actually accomplished and who (cost per minute) and where (rent per minute) is the resource used during each task, the total cost of each patient encounter can be calculated. With the revenue per pediatric encounter that is available from the practice management system (a fiscal application), the profit per each encounter can be calculated.

By comparing encounter profitability across similar medical practices, specific reasons for decreased profitability can be located: (1) a step is more expensive per minute than it should be (that is, it is accomplished by less expensive resources at other medical practices), (2) a step takes longer to accomplish than it should (compared to other practices), and (3) a step is executed more frequently than it should (compared to other practices). The win-win-win analytic result is to find those too expensive and too long steps being executed too often and change the workflow to increase encounter profitability.

That’s just one example of the power of combining EHRs, BPM, and cost data.

So, to answer your question: “In the healthcare environment, are their institutions using BPM software platforms in conjunction with ERP (fiscal) and EHR (medical platforms)?”:

There are a couple of mature existence proofs that EMR/EHR workflow systems/BPM platforms work well and have excellent potential. A metaphorical light bulb is turning on over the collective heads of the healthcare IT industry. And there are excellent questions like yours. Thank you for asking it!

P.S. I couldn’t figure out how to insert URLs into the Six Sigma website answer text box. However, I recently added links to more material about BPM in healthcare at http://wareflo.com/ehr-workflow-ehrs-wfmss

Zowie! Tweets of the Week for January 24, 2010: Traditional EMRs, Metaphysical Certitude, Peach of a Pediatric EMR, Most Downloaded White Paper

Coming to HIMSS in Atlanta? Find the Peach (of a Pediatric EMR), Arrange A Demo, Visit a Practice

Short Link: http://j.mp/54pdxJ

[This post was published before the 2010 HIMSS conference in Atlanta. The conference is over but our offer still stands!]

Are you a pediatrician coming to the Health Information and Systems Society Conference this March 1-4, 2010, in Atlanta, Georgia? You should know something:

You are coming to our town!

atlanta-panCan You Find the Peach?
(Click to zoom in)

As I wrote this June in “Georgia’s Best EMR Used By Three of Top Ten Pediatricians”, thirty percent of Georgia’s top ten pediatricians (EMR users plus non-users) use the EncounterPRO Pediatric EMR Workflow System. A Georgia Chapter of the American Academy of Pediatrics survey indicates forty percent of pediatricians in the State of Georgia who use an EMR use EncounterPRO.

We have a particularly high concentration of pediatricians in the Atlanta metro area who use EncounterPRO. My own back-of-the-envelope calculation, based on estimates of how many pediatricians live and work in the Atlanta metro region and how many pediatricians use a comprehensive EMR, plus our own customer statistics, leads me to believe that more than half of the pediatricians who use a comprehensive EMR in Atlanta use the EncounterPRO Pediatric EMR Workflow System.

If you are coming to Atlanta for HIMSS we would love to give you a live demo and/or arrange your visit to a pediatric practice in Atlanta using the EncounterPRO Pediatric EMR. Just use the form at the link below and we will pick you up at your conference hotel or the Georgia World Congress Center, transport you to our headquarters and/or a pediatric practice, and deliver you back to your hotel or conference venue.

And, if you can find the peach in the zoomable panoramic Atlanta skyline, we’ll enter you into a drawing for a crisp brand new C note (AKA one hundred semolians).

peach-buck2

100 Peach Bucks

Provide contact information to visit EncounterPRO, get a face-to-face demo, and/or visit a pediatric practice using the EncounterPRO Pediatric EMR Workflow System.

P.S. Even if you are not coming to Atlanta anytime soon, we’d still love to give you a demo of a pediatric EMR that is the opposite of the traditional clickity-clickity-click-click-click, hunt-and-peck, point-and-click EMR (pediatric or otherwise).

2009 Number One Downloaded Article on Healthcare Technology Online: My White Paper on EMR Workflow, Usability, and Productivity in Pediatric and Primary Care

Short Link: http://j.mp/6JDKAV

Gosh! (Fake humility intended.)

I was having writer’s block problem. It’s not that I don’t have enough ideas, but rather that I have too many. They jostle and shout “Me!” “Me!” “Me!” and sometimes I don’t have a good way to prioritize. (Maybe I need something like the EncounterPRO Pediatric EMR Workflow System’s big picture “radar view”—AKA Office View—which helps prioritize pending tasks.)

2009-top-10-doc_hto

Then this came in over the transom. Last year my white paper on “EMR Workflow, Usability, and Productivity in Pediatric and Primary Care” was the most downloaded article on Healthcare Technology Online.
 
Since old news is no news (this was announced on December 22nd, but I was on beach holiday and did not notice, was I too busy tweeting?  Perhaps I should have been following @HCTechnology on Twitter?) my decision about what to write about was effectively made.  However, folks wouldn’t have been paying attention back then anyway. Now that folks are reattaching the Web to their brains, maybe it’s for the best.

The article on Healthcare Technology Online republished my blog post “A White Paper About EMR Workflow, Usability, and Productivity in Pediatric and Primary Care” about the longer (and more technical) white paper “Pediatric and Primary Care EMR Business Process Management: A Look Back, a Look Under the Hood, and a Look Forward.” That white paper was in turn an update to my 2003 white paper “Electronic Medical Record Workflow Management: The Workflow of Workflow” By the way, please see instructions at “Could You Do Me a Favor? “Electronic Medical Record Workflow Management: The Workflow of Workflow” so I can keep that at the top of Google for the search terms “EMR” plus “workflow” (http://www.google.com/search?q=emr+workflow )

Thank You!

First and foremost I’d like to thank all the little people who made this possible—the children whose pediatricians use our product, the High-Usability EncounterPRO Pediatric EMR Workflow System.

Second, thank you Ken Congdon, chief editor at Healthcare Technology Online, for republishing the white paper at just the moment that a giant light bulb turned on over the collective heads of the healthcare information technology industry.

But most of all I’d like to thank family physician Geoffrey Wittig, M.D. He wrote the letter to the editor at the New York Times, about the impact of traditional EMRs on the high-volume, low-margin business of primary care, which caused me to update the original EMR workflow white paper.

“A high-volume, low-margin business like primary care medicine simply cannot support the costs. These include both the very high dollar cost of buying and maintaining a system and the huge drop in productivity that initially accompanies implementation.”

May your common sense rule the day.

P.S. “Me!”, “Me!”, “Me!”

Zowie! Tweets of the Week for January 17, 2010: Twitter Holiday, Groupware, EHRs+BPM, Football, Most Downloaded White Paper

  • Blog post: A Twitter Holiday: Sun, Sand, Surf, Smartphones, Short URLS, Social MEdia, and Pediatric EMR Workflow Systems http://j.mp/4ogmwT #
  • “Groupware” coined in 1978 “intentionally chosen group processes & procedures + the computer software 2 support them” http://j.mp/8YHaiY EMR #
  • Good question! Are any healthcare institutions using Business Process Management (BPM) with fiscal and EMR/EHR apps? http://bit.ly/5aP8Jl #
  • TX RT @tmlfox “Football Plays & #EHR Workflow” The comments R as good (or better) than the blog entry itself. Fun read http://ow.ly/VwVT EMR #
  • Hmm. No 1 going to answer twestion http://j.mp/4vuX7z on status of combined use BPM, EMR/EHR & fiscal apps? This looks like a job for…moi! #
  • Greif 1988 “The multi-user software supporting CSCW [Computer-Supported Cooperative Work] systems is known as groupware” http://j.mp/8BkDbP #
  • Hey! My white paper on pediatric emr/ehr workflow most downloaded 4 2009 @ Healthcare Technology Online http://j.mp/7EwGJM TX! @hctechnology #

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A Twitter Holiday: Sun, Sand, Surf, Smartphones, Short URLs, Social MEdia, and EMR Workflow Systems

Short Link: http://j.mp/4ogmwT

You will notice something new at the beginning of each post to this blog: “Short Link:” followed by a short and somewhat cryptic URL (http://j.mp/4ogmwT). If you click on it (try it!) you simply end back where you started, on this same page.

What’s the point? Short URLs, or short links, are used in SMS messages and Twitter tweets, which are a maximum of 140 characters long. At eighteen characters, the short link leaves 122 for the trenchant, piquant, pithy, and necessarily concise tweets about what you are doing or thinking.

Why am I doing this? In fact I’ve avoided Twitter for the same reasons I initially avoided blogging. The phrases “self-indulgent,” “banal,” and “navel-gazing” came to mind. For example, the following study found that 40.55% of tweets are “pointless babble.”

tweet-content

Then last February I registered http://twitter.com/chuckwebster (so my Twitter handle is @chuckwebster). While Twitter was new (to me, it’s been around since 2006) if it turned out to be important I wanted to be *the* @chuckwebster of out estimated 613 Charles Websters in the US to have that account, not @chuckwwebster or @chuckwebster5.

A use for Twitter that immediately made sense to me was real-time microblogging of a live event for folks who cannot attend. So I sent 40 tweets in 60 minutes at Dr. Gonzalzle’s presentation “Workflow Management EMR Systems and the Primary Care Physician” at the HIMSS conference in Chicago last April. Fun to do once but exhausting (lots of typos too), and I don’t attend enough such events to merit further investigation (or so I thought at the time).

Your Personal Twitter Timeline as a Thought Stream

I continued to read about business uses for Twitter. Then I had lunch with someone very knowledgeable about Web who used to agree with me about the apparent pointlessness of Twitter, but who now has 240 “followers.”

Dave: I’ve got 240 followers on Twitter.

You’ve got 240 followers on Twitter?!

Dave: That’s what I said.

What do you tweet about?

Dave: Thought of the day, interesting quotes, links to interesting articles, that sort of thing.

That’s nice, but why bother?

Dave: It’s fun, some interesting people follow my tweets and I follow them too. And folks are clicking through to my other Web sites.

Oh! (Hmmm…web traffic…maybe I was a bit hasty!)

Thought of the day…thought stream…Twitter recently changed the question above its tweet submission box from “What are you doing?” to “What’s happening?”, encompassing more interesting material than “Having breakfast.”

Then I read about research (“Study Reveals Two Types of Twitter Users” and “Is it Really About Me? Message Content in Social Awareness Streams”) that divided Twitter users as Meformers versus Informers, “two different types of ‘content camps’: a majority of users focus on the ‘self’, while a smaller set of users are driven more by sharing information.” That second set of users sound a lot like me (or at least how I like to think of myself).

Coincidently, at the same time I read about Twitter Informers, I stumbled across a list of WordPress plugins that help coordinate Twitter and WordPress. I realized that I could use my tweets to generate content on this blog (scroll down to the bottom of the right-hand margin on this blog). Since each new tweet causes the oldest tweet to disappear, I’ve “archived” a set of tweets to the end of this post so I can refer to them below.

During my recent holiday vacation I wasn’t going to have access to my laptop at the beach. I faced writing two posts and scheduling them to be published automatically on vacation. I will tell you the truth. That felt like work. And I write this blog because it is fun. Was there a way for me to conveniently submit material to this blog from my smartphone? It would give me something to do while soaking in the rays.

I then began to think about my Twitter account as a convenient mobile extension to this blog. The fact that it would *only* allow me to submit 140 characters at a time was almost a relief (I do go overboard). It was almost an enforced “stop working so hard.” Just have fun exploring something new and if what I post is self-indulgent, so what, it will just be lost in the noise and eventually disappear in a massive haystack of other inconsequential tweets.

Then the snow storm hit DC just before my wife was about to fly down to Key West and the best real-time news (compared to cable and even the Web) I could get about DC travel conditions was Twitter. I tracked the key words “DC”, “DCA” (Reagan National Airport), and “snow” plus the hash tag “#snowpocalypse”. Here was a source of real-time news alerts that was really useful.

Huh. I was impressed.

In the meantime, sitting at the beach, I’m reading about different Twitter applications, culture, and uses. Eventually I began to think of my own tweets as resembling the email reminders I already send myself.

Using just the email subject line, I often send myself emails with subject lines starting with “remind think about…”, “remind what is connection between X and Y?”, “remind blog post idea: …” and “remind cell photo pretty sunset at piedmont park” (with attached image). Sometimes I include a Web URL in the email body. When I get back to my office or laptop I sort my emails in outlook and go back and data mine this “thought stream” (wasn’t I thinking about X a few months ago, ha! here’s the link I was looking for).

While an email subject line can hold more than 140 characters, it is similar to a tweet: telegraphic, no formatting, targeted audience. So I decided to conduct an experiment. For the next two weeks, over the recent holidays, I resolved to not touch my laptop. I’d just use my smartphone to access the Web and update this blog. I would post once or twice a day, and while I’d try to be an Informer, I’d give into a Meformer urge once in a while, just so I could understand that inclination.

It was fun. I “meformed” a bit more than I intended: vacation photos, a bit of doggerel when bored, an obscure reference to Michael Keaton’s character in the Night Shift. Hey, I was on vacation. But I also found some interesting content on the Web that I wished to remind myself to explore and possibly post about later (and didn’t mind if anyone else eavesdropped).

If I go back over my recent tweets they appear to fall into one or more three categories:

  • Informer-style Branded Content: Comments, quotes, and links related to the EMR workflow systems that will likely continue. (13 tweets: green bullets)
  • Informer-style Unbranded Content: Such as material related to Twitter itself. It’s the new thing that I am currently learning about, thinking about, and excited to share. This content will likely wax and then wane, to be replaced about whatever intrigues me next. (7 tweets: blue bullets)
  • Meformer-style Content: Of most interest mostly to me, a relative or a friend. (3 tweets: red bullets)

Plus a more recent short video tweet that spans all three categories: Branded Informer (mention of EncounterPRO), Unbranded Informer (look, I can tweet a video!), and plain ‘ol Meformer (“It’s cold here in Atlanta!”).

URL Shortening Services

Oh. So why am I putting URL short links my blog pages and those of our product website? So I can tweet them. So you can too. For example, coincident with publishing this blog post I tweeted “Blog post: Twitter Holiday: Sun, Sand, Surf, Smartphones, Short URLS, Social Media, and Pediatric EMR Workflow Systems http://j.mp/4ogmwT” More and more people surf the Web on their cell phones and communicate using Twitter. If you want to tweet one of my blog posts or our product pages, just copy and paste the Short Link into your tweet.

On the other hand, you could go to the trouble of creating your own short links at one of the many free URL shortening services. Why did I choose j.mp? If you look back over my tweets (below) you may notice that I tried different URL shortening services: http://bit.ly (favored by Twitter), http://multiurl.com (enables tweeting more than one URL, each with a description), and http://j.mp (two characters shorter than bit.ly, but also belongs to bit.ly). I chose j.mp because it results in an exceptionally short URL (18 characters) and because it belongs to bit.ly, a Twitter partner and therefore not likely to go away soon.

Conclusion

That’s how and why I started twittering. Is Twitter the greatest thing since sliced bread? I don’t know. I recently read that national and international use of Twitter from the desktop Web browsers is flat lining, but that smartphone access continues to grow. This is consistent with my experience; I didn’t see the point of Twitter until I realized what I could conveniently use it to do things from my smartphone.

Right now, Twitter is a way for me to interact with my blog in both real time (the direct feed) and to publicly, but informally, archive ideas for future posts. Sort of miniature trailers for potential longer attractions to come. Therefore many of my future tweets will be about the same subjects I address here in the blog: EMR workflow systems, their usability, and the extraordinary potential for applying business process management techniques to improving healthcare processes.

Since I’ll be attending HIMSS here in Atlanta March 1-4, maybe I’ll try to live blog that from my smartphone. I can bump my live feed of tweets to the top of this blog’s right-hand column (replacing the photo of  our kickbikes) so it will be hard to ignore. Check back then (even if you aren’t a regular reader).

Also, (surprise!) sometimes I just don’t know when to stop writing. Since brevity is the soul of wit, maybe Twitter can teach me to be (t)wittier. I just don’t know. But I am interested in finding out.

If you are interested in finding out too, or interested in some of the same subjects as I am (EMRs, workflow, usability, cognitive science, kickbiking, and, for the moment, Twitter), and you have a Twitter account, I hope you’ll follow me (I’ll likely follow you right back). If you don’t have a twitter account, head over to www.twitter.com get one: free!

Tweet you later!

@chuckwebster

Archive of Recent Tweets as of Date of this Post, Color-coded by Category (Green •: Branded “Informer,” Blue •: Unbranded “Informer,” and Red •: “Meformer”)

(from newer to older…)

Wishing I was in Key West…sunset-235-wide1…tweeting from the beach…

· End Key West Twitter Holiday 🙁 Is my wife wearing a cruise ship for a hat? http://www.twitpic.com/wcxn4 Will I continue to tweet? Que Sera Sera! 4 days ago

· Test: Shortest URL shortener? Which links work? http://en.wikipedia.org/wiki/URL_shortening http://j.mp/8XKXlo http://www.j.mp/8XKXlo j.mp/8XKXlo 5 days ago

· Wanna no y I have a Twitter acct? To tweet things. See, I got ideas coming at me all day. I couldn’t fight’em off if I wanted Happy New Year 6 days ago

· Blog post idea: recent article care coordination gap » EMR workflow systems = EMR care coordination systems http://j.mp/5n0E1d Pediatric EHR 1 week ago

· MSFT”use [workflow] model to interpret behavior [and to] reason…how to optimize the business process” http://j.mp/6ntnVa Pediatric EMR EHR 1 week ago

· MSFT”which individuals are contributing work to which business process…to understand costs and workloads” Pediatric EMR http://j.mp/6ntnVa 1 week ago

· http://twitpic.com/vc8nv Mobile Office: subject usable EMR workflow, locale beach, 1999 technology PALM VII–readable in direct sunlight! 1 week ago

· MSFT”Workflow models can be used to gain insight into the flow of work through an organization” Pediatric EMR http://www.multiurl.com/l/0Oi 1 week ago

· Microsoft “Benefits that a workflow model can bring are insight, monitoring, and optimization.” Pediatric EMR http://www.multiurl.com/l/0Oi 1 week ago

· There once was a tweet, a bit of a cheat, that did not obsess, or even address, the author’s central conceit http://bit.ly/6dkU7o Merry XMas 1 week ago

· Cycle time from 80 to 30 minutes, improved bottom line and patient satisfaction http://bit.ly/8NeKZn quote EncounterPRO pediatric EMR user?? 2 weeks ago

· Watch http://ehrworkflow.com for new EMR / EHR workflow and usability pediatric, subspecialty, family medicine, OB/gyn. content…developing 2 weeks ago

· Read about pediatric EMR workflow systems at http://wareflo.com/pediatric-emr-workflow 2 weeks ago

· Groupware versus Workflow http://bit.ly/8nzRQd need both clinical groupware http://bit.ly/57uxWG and pediatric EMR WfSs http://bit.ly/6DeFlE 2 weeks ago

· “Products designed to…reflect…work patterns of physicians…reduce EHR implementation difficulties” http://bit.ly/8WoBp2 arg 4 EMR WfSs! 2 weeks ago

· http://twitpic.com/u7qfw – Arrived in Key West. Here’s the view out the window. (Grin!) 2 weeks ago

· Merry Christmas and Happy New Year from Key West! http://bit.ly/602CpE Check out my “Twelve Days of EMR Beta Testing” http://bit.ly/83b6Uv 2 weeks ago

· Idea: Complex Event Processing http://bit.ly/8YltPT and Pediatric EMR Workflow Systems, user-defined events trigger automated workflows 2 weeks ago

· I’ll try to be more of a Twitter Informer than Meformer. Read about social awareness streams at http://www.bit.ly/PUcvD and http://www.bit.ly/3JEtPb 2 weeks ago

· …worked like a charm! 2 weeks ago

· Going on vacation, want to post ruminations from the beach, installed Twitter Tools for WordPress, let’s post a test tweet to my blog… 2 weeks ago

· Audience member caught up with me, is your system enterprise ready, what do you mean? Handle multiple specialty workflows, absolutely! 2009-04-05

· That’s it for ed sessions today. Nw to find a coffee house, get online, and do some work. Thnks fr following my twitter updates this morning 2009-04-05


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Bill Blazejowski (Michael Keaton’s character in Night Shift)

“Wanna know why I carry this tape recorder? To tape things. See, I’m an idea man Chuck. I got ideas coming at me all day…I couldn’t even fight them off if I wanted. Wait a second…hold the phone. Hold the phone!

[Speaking into the phone]

Idea to eliminate garbage. Editable paper. You eat it, it’s gone. You eat it, it’s outta here. No more garbage.”

Zowie! Tweets for Week Ending 1/10/10: EMRs, Workflow, Groupware, Short Links, Chess Boxing, and Short Video of Frozen Waterfall

Short Link: http://bit.ly/5lKpYZ


  1. Early groupware/computer-supported cooperative work relevant to clinical pediatric EMR/EHR workflow & usability http://www.twitpic.com/xddkk about 23 hours ago
  2. Current ski conditions for Key West, Florida (I kid you not, check out this screen shot) http://www.twitpic.com/x5jw9 8:11 PM Jan 7th 
  3. http://j.mp/7mTLDm Testing new short-linked pediatric-specific High-Usability EncounterPRO EMR Workflow System website, does this link work? 7:47 PM Jan 7th 
  4. http://twitvid.com/B97D2 – Video News Flash! Atlanta Chill: Waterfall by EncounterPRO Pediatric EMR Workflow System headqtrs freezes solid! 7:06 AM Jan 7th 
  5. “Medical practices are a home-grown industry, really a cottage industry, so every single one is different.” http://j.mp/7Xluox Arg 4 EMR WfS 8:39 AM Jan 5th 
  6. Natural EMR EHR workflow “fits” tasks w/o work arounds, is normal, logical, expected, st8 4ward, “intuitable” based on prior user experience 8:42 AM Jan 4th 
  7. RT @AMFitnessCoach “Tru njoyment comes from activity of the mind & exercise of the body; the 2 are united.” Chess Boxing! http://j.mp/8h1c1A 7:44 AM Jan 4th 
  8. Tape recorder! Idea 4 blog post: Sun, Sand, Surf, Cellphones, Short URLs, Social MEdia & Pediatric EMR Workflow Systems www.chuckwebster.com 10:35 AM Jan 3rd