I don't code for a living, but I code on a regular basis off and on for minor projects. I believe that commenting your code is essential, and touch typing is perfect for that. I have some uncommented APL code from long ago and I will never be able to figure out how it works and tweak it. I am now 72, and I am so grateful that my mother made me take a typing class when I was just a kid. I was really embarrassed that I was the only boy in the class, until I realized this made it much easier for me to get dates. Let me offer a parallel to coding. I am working on a textbook, and nobody makes any money off of textbooks, not the contributors nor the publishing companies. In this day and age, free online information, whether supported by ads or just contributed because you want recognition, and a sense of helping others, is where it is at. It also makes it much easier to just grab graphics off of Wikimedia Commons and drop it in because my textbook is offered under a Creative Commons license. I am doing all of the typography, page layout, graphics design, and typing everything directly in InDesign. Which means I do a lot of typing. Because I can do creative work better while typing than speaking. Once you learn touch typing, that skill goes into your basal ganglia. That's where muscle memory lives. That allows you the higher parts of your brain free to critique what you are typing and be thinking about things other than where your fingers are going. If I have a completely preformed thought that just needs to be brain dumped, and doesn't have any weird symbols or words in it, like this reply, I can certainly use speech recognition and it works sort of okay. But I am having to be so careful about proofreading, because speech recognition always puts in a word that it recognizes and therefore a spell checker doesn't find the errors like a typing error that gets flagged, that proofreading is so very hard. It's really hard to proofread stuff that you just dictated. Search for Ode to a Spellchecker if you want examples of what a spell checker will not find when you dictated, even though it was written long before speech recognition. And just think about how much worse this is with dictated text. I cannot really think while I am dictating this which is an important quality check for me. I thought about the parallel of using AI to try to create some of my text or code. I figure that I should only delegate tasks to an AI which I would be happy to delegate to a hyperintelligent, well-read, autistic, psychotic 6-year-old sociopathpath.

Doesn't anyone read Terry Pratchett? As in, "The Colour of Magic?" The color is obviously octarine!

Disclosure: I am an emergency physician and a professor at a University. The vast majority of things I do, and that I teach my students and residents to do, are not based on double-blind, placebo-controlled trials, but on weaker evidence, or case studies. Why? Because we don't have such high-quality evidence for most of the decisions we have to make, and we have to make the best decision we can based on the available evidence. But as with the basic sciences, our knowledge is always subject to change, and I expect that stenting for stable angina is likely to go the way of cupping and leeching. I will leave you with a thought from Judith Tintinalli, M.D., a well-known emergency physician, who talks about "six dangerous words": “There is no evidence to suggest that a parachute saves lives when jumping out of an airplane.” “There is no evidence to suggest that looking both ways before crossing a street prevents accidents.” “In a patient with a first seizure who has returned to baseline, there is no evidence to suggest that a CT scan obtained in the ED affects outcome.”

As a long-time but hobbyist programmer (started with machine code before moving to A86 assembler), I found the discussion thoughtful and illuminating. I will therefore offer a snide comment that may contain a grain of truth, based on something I heard when I first began to code, but updated a bit. "Strong typing is for weak minds. But coders overestimate the strength of their minds."

I am posting this mostly because it is so bizarre that even I have trouble believing it. I still take my medical notes (on a laptop with 2 128 GB SSDs in RAID0) in a 280k, $10 shareware DOS program called HyGen, developed by one of the early pioneers of hypertext, Neil Larson of MaxThink fame. It is a non-html hypertext program, where links in reference ASCII text DOS file names. Thus, with a simple DOS text editor (I use Qedit), you can take notes by typing, create new .TXT files, and link them manually. I do occasionally use UltraEdit to edit the files to paste in information from Windows. but the DOS text editor is so quick on a modern laptop that I preferentially use it for taking notes. This is perhaps the electronic equivalent of charcoal on papyrus, but I have to admit I've not found a more modern method that allows both creating and browsing hypertext fast enough to take notes in class. I did try Amaya and thought about converting it all to html but wasn't happy with the it compared to the DOS method. And yes, this old program won't run under Win7 command prompt, but it will run well in a DosBox. An older version of this is available on SimTel: http://www.simtel.net/free/Development-Hyper-Text-files-and-programs/hyplus-zip/46728.html A zip file with Hygen and Qedit (both shareware, if no longer readily available) and my current ASCII text hypertext-linked files is available at: http://www.conovers.org/ftp/Notebook.zip Remember, you may have to run it in DOSbox. Caveat: my medical notes are full of errors and you use at your own risk. And these are notes what I, as an experienced emergency physician, find useful, so you may not. If anyone actually decides to use this for medical notes, please let me know!

We previously discussed all the articles in the press about Waldorf schools http://tech.slashdot.org/submission/1826506/a-silicon-valley-school-that-doesnt-use-computers. Waldorf schools have balls. And rocks. And knives.

My daughter is now 12 and in sixth grade at the Waldorf school here in Pittsburgh. She's been going there ever since nursery school.

When I first visited the Waldorf school to see if I wanted my daughter there, I went into the nursery class. I looked at the toys there, which were all "natural" and indeed, the wooden and knitted toys had all been made by kids in the upper grades. But I saw a big basket full of river rocks. "You give these to kindergarten kids to play with? Won't they throw them at each other, or hit someone in the head?" "Well, one of the main things we teach in preschool is socialization. Kids have to learn how to not do things like that. So we don't see any problem."

In the kindergarten, kids bake their own biscuits in the oven for snack, and use sharp knives to cut up apples for the snacks as well. "Kids need to learn basic safety, and the earlier, the better."

Out in the play yard, there was a sign with a list of rules. One of them was "No smearing mud on the fence or buildings." Didn't say anything about other kids or even teachers. There was also a rule about climbing trees. One tree was OK for all kids to climb. The other was only for those in the upper grades, as the limbs were too far apart.

The Waldorf school kids get their share of bumps and bruises, most of which don't get reported as they get up, dust themselves off, and keep going. Doesn't seem to be much in the way of major injuries, though. And the kids are always remarked-upon as seeming "mature for their age." I guess bubble wrap is bad for fostering maturity.

Which brings up a question. In middle school, our Waldorf school will teach basic computer programming, and has a fair bit of latitude in doing so. So, for such a school, what's the best way for them to learn it? I admit that I have a predilection for the way I learned it: setting little switches and then pressing a button to program our medical school's Cromemco Z-80 computer byte by byte, learning all about registers and PUSH and POP by actually doing it; only later doing things in assembler. Seems properly Waldorfian, though perhaps the students should have to build the computer with soldering irons. What do you think?

If the goal is simply to have users remember the error message, there is some science on learnability and memorability.

See http://ed-informatics.org/2009/12/28/computers-in-the-ed-1/

First of all, if you read about evolutionary psychology, say, the works of Merlin Donald, you will realize that people are designed to remember stories and not numbers, so you could have each error message tell a different story.

See http://ed-informatics.org/2010/01/07/computers-in-the-ed-5/

Or, you could reference the work of Colin Ware, and design error messages that have icons that use preattentive attributes.

See http://ed-informatics.org/2010/01/25/computers-in-the-ed-8

and

http://ed-informatics.org/2010/02/11/computers-in-the-ed-9/

While this tends to answer what you asked, which is to help users remember error messages, some of the other proposed solutions already posted may actually help solve your problem better (debug logs, etc.).

First off it's a good idea to define terms, as the risks for the various flavors of medical record differ. And, given that for the USA, at least, we now have some terms that are official, here's a summary from the document I recently put together for a medical IT conference, referenced at the end of this post.

EMR vs. EHR vs. PHR?

Many people use the terms electronic medical record (EMR), electronic health record (EHR) and personal health record (PHR) interchangeably. But arguably they mean very different things.

There are also a great variety of other terms used to describe electronic records, but EMR and EHR and PHR are now more-or-less accepted as the three real terms. In fact, the US ONCHIT commissioned the NAHIT to develop definitions and so, at least in the USA, these are official.

An EMR is just that - an electronic record of an episode of medical care, whether inpatient or outpatient or ED. The EHR is both more and less than the EMR - it is those parts of the EMR that are appropriately shared with stakeholders outside the hospital, doctor's office or other EMR source. Parts of the EMR are shared, as the EHR insurance companies, government agencies, patients themselves, and employers. An article in Medical Economics, quoting an Institute of Medicine report, defines the elements of an EHR thusly:

Health information and data. The system holds what's normally in a paper chart - problem lists, medication lists, test results.

Results management. An EHR lets you receive lab results, radiology reports, and even X-ray images electronically.

Order entry. No more prescription pads. All your orders are automated.

Decision support. An EHR is smart enough to warn you about drug interactions, help you make a diagnosis, and point you to evidence-based guidelines when you ponder treatment options.

Electronic communications and connectivity. You can talk in cyberspace with patients, your medical assistant, referring doctors, hospitals, and insurers - securely. And your system interfaces with everyone else's. Interoperability is the key word.

Patient support. Patients can receive educational material via the EHR and enter data themselves through online questionnaires and home monitoring devices.

Administrative processes. The system lends a hand with practice management. Patients can schedule their own appointments and staffers can check on insurance eligibility.

Reporting and population health management. How many patients did you treat for tuberculosis in 2003? How many of your diabetics have their HbA1c under 7? An EHR will spit out the answers, thanks to a searchable database.

A Personal Health Record is just that: personal. It is those parts of the EMR/EHR that an individual person "owns" and controls. Google and Microsoft want to help you with this. (Really.)

If these definitions seem a bit vague, well, yes, they are, because we're just getting started with this stuff, you know?

A more complete tutorial on Healthcare IT, with a diagram that might make the above actually make sense, as well as links, may be found in a PDF named

Healthcare IT in a Nutshell.pdf

at:

http://ed-informatics.org/healthcareit/ [ed-informatics.org]

(BTW, as a practicing ER doc, when I need EHR info, I need it NOW, often 10 minutes later is useless.)