For year’s EHR vendors created EHR shells with functionality that lacked all of the creamy goodness of evidence based medicine. Instead they have left it up to the hospitals to do this.
This has not worked well. Who wants to buy the cream puff shells at the bakery then go home to make your filling? I just want a damn cream puff. Adding the evidence-based medicine to an EHR is an amazing amount of work that literally takes a decade before the average health care organization can scratch the surface.
I read this blog post today that describes Cerner’s plans to use British Medical Journal (BMJ) clinical content: http://bit.ly/9vJEfb. Dale Sanders, CIO, Cayman Island Health Authority has written an excellent post with exuberance.
This seems to be much more connected and thought out than the pseudo-partnerships we see today between EHR vendor’s and tools such as Zynx.
This is the kind of thing that can be disruptive to the EHR market. That is, it could knock Epic off the top of the mountain.
Candid CIO 
Putting EBM into the clinician’s workflow is one of my dreams, too! Why not have it as part of the EHR? That’s where the doctors spend their time. It has been a complicated process, but the tools are maturing, too. Sure beats waiting 17 years for the changes to get picked up in clinical practice. I think we’re getting there …
Your Librarian,
Michele
I’m confused about the last point around Epic. Don’t they now have a model build based on EBM, or am I wrong?
Also, where do you rate “built in” EBM vs integration across the continuum of care? More or less important???
No, I do not believe Epic has fully established EBM in their products. If it did, it would come pre-configured with Order Sets, for every conceivable condition, using nationally standard order codes. If they have accomplished this let me know so I can get in line. I believe Epic’s new model system has more to do with workflow. While I am sure there is some EBM built into various aspects of the system, it is far from comprehensive.
I believe the notion of an integrated EHR across the continuum of care is a bit if a myth. Are all of your admitting physicians using your EHR? Is every primary care provider in your community using your EHR? When patients transfer to a tertiary care hospital, is that same EHR still used? Somewhere the patients that we treat are receiving care that is documented somewhere other than our EHR. But, I understand the strategy of using as few applications as possible in order to simplify operations and integration challenges. Still, if I could have an off the shelf solution, that hardwires proper care based upon all of man’s medical knowledge I would take that even if it required me to embrace best of breed.
Here is a useful new website you might want to consider:
Biomedical Device Integration Tech Corner
http://bmdi-tech-corner.com
“An archive of technical documents, protocols, standards and procedures useful for clinical engineers and IT professionals involved in biomedical device integration and connectivity to electronic medical records (EMR)”
You can find some great Long Term Care and EHR resources on http://www.ltcadministrator.com. If you’re interested in EHR, you may want to take a look at medicalsoftware.com, 4dmed.com and medical-billing.com.
Great thread here ..I recall reading it August 2010.. and a good refresher in June 2011 !