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Today’s EMR Knowledge Management Capabilities:
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Knowledge “hardwired” or structured in proprietary modes into
applications, not easily updated or shared
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Little or no standardization of HIT vendors on SNOMED, no
shared interface terminologies for observation capture, no standard
order catalogues
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Most EMRs have a task-interfering approach to decision support,
sub-optimal usability, limited surveillance support
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Knowledge-engineering tools typically edit into transaction, no
support for provenance, versioning, life-cycle, propagation,
discovery or maintenance
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Consequently, clinical systems implementations are
under-resourced with adequate knowledge to meet research, safety
and quality needs
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Labor of converting knowledge into Clinical Decision Support is
vastly underestimated
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Doesn’t bode well for personalized medicine