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To the Editor: An Editorial by Drs Wears and Berg¹ and an article by Dr Koppel and colleagues² provided a critique of the current state of affairs of health care IT, specifically computerized physician order entry systems and clinical decision support. These articles suggest that the difficulties associated with computer-based medical assistance tools are so deep-rooted that, perhaps, these efforts should be curtailed or significantly redirected.

Wears and Berg note that clinical work and IT systems are fundamentally different; the former is described as interpretative, opportunistic, and multitasking, while the latter is linear, rationalized, and single-minded. The authors thus suggest that it is possible that these 2 entities can never effectively work together. However, this perspective may lead to missed opportunities.

One of the sources of health care IT problems is that the planners and developers of the national electronic health record (EHR) and the National Healthcare Information Infrastructure are . . . [Full Text of this Article]

Peter P. Mitchell, PhD
pmitchell@med.miami.edu
Center for Patient Safety
University of Miami/Jackson Memorial Hospital
Miami, Fla

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