Small is Beautiful

As noted in early blogposts, there are active discussions in several countries, notably the US, UK and Australia, about the wisdom of large scale EHR projects.  A recent Millbank Quarterly study examined hundreds of previous studies on EHR implementations and, according an HealthBeat article (, the researchers involved in the study suggest that “small, local EHR systems tend to be more effective and efficient compared with larger systems.”   As I have argued in past blog posts and my most recent Healthcare Information Management & Communications Canada “Last Words” article, healthcare delivery is an ecosystem that consists of many co-operating players and not a single enterprise.  Hence, the suggestion that local systems are mroe “effective and efficient” is not suprising to me.


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