Having worked in the VA for about 28 years and having worked in a primary care clinic that had purchased eClinicalWorks, I was able to compare VA VisTa with eClinicalWorks. VA VisTa's CPRS has a free text clinical note centric means of entering clinical information with availability of templates, clinical practice guidelines, CPOE and "form filled hypertext" entry of information into the clinical note. CPRS has an annotatable problem list where one can annotate key information per problem over time.
eClinicalWorks has a template driven centric means of entering clinical information with availability of relatively small "cells" where free text information can be entered. eClinicalWorks did not have an annotatable problem list or one where it is possible to enter problems that are not ICD-9 coded (as of when I last used it in Oct 2008). In a visit to the eClinicalWorks website and a call to their sales line, I was unable to affirm that they have an annotatable problem list. The "dump data" template-centric focus continues unabated and is not apparently different in the soon to be released EHR form of eClinicalWorks.
I found myself constantly frustrated by the above comparison since I felt eClinicalWorks was forcing me to "dump data" into the clinical note using templates and it did not have an annotatable problem list that I could refer to instead of reading through progress notes pertinent to specific problems to get the "gist" of what was happening in the continuity and breath of care of the patient.
If those deficientcies have not been corrected in eClinicalWorks I predict there will be some major league frustration among real clinicians working in the SF Dept of Public Health.
