Re: Ready or not

Issue: BCMJ, vol. 51, No. 7, September 2009, Page 287 Letters

As a former industrial manager involved in information technology development some 40 years ago and spouse of a retired radiologist, I found Dr McMahen’s comments on EMR in the June issue particularly interesting (“Ready or not” BCMJ 2009;51[5]:190).

Implementation of an information system that does not produce the results for which it was intended is always a mistake. It’s hard to get people back on board after they have been turned off by something inadequate and time consuming. As an ex-hospital board member I also remember the implementation problems with the original MEDITECH system that actually increased the work for lab techs at the time.

It is absolutely essential that the people who are going to use a system are thoroughly involved in its design. An individual or group of users needs to take on the leadership and insist that this happens if they have not done so already. I remember being of minor assistance to psychiatrist Dr Philip W. Long when he decided to produce a psychiatric expert system just as I was assembling my first personal computer in 1977. 

Later on, Dr Long hired programmers and spent time most days between patients dictating the design of the system. He now has at least two web sites, and Both, I am sure, have been very useful to his field, and he has been honored for their development by the BC and Canadian psychiatric associations. He certainly got involved.

I have memories of working for Canfor when a systems group at the Bentall Centre in Vancouver was trying to tell us at the pulp mill, miles away, how to develop a system. It took some time for them to learn that they were not at the centre of the world, and we needed to be deeply involved before something useful was achieved.

If a group of physicians does not take leadership and step forward to see that a fully functional system is developed, you may get something that is more of a millstone than an asset. It is certainly time that you had such a useful system. I hope my comments are useful.

—Bernie Littlejohn
Williams Lake

Bernie Littlejohn,. Re: Ready or not. BCMJ, Vol. 51, No. 7, September, 2009, Page(s) 287 - Letters.

Above is the information needed to cite this article in your paper or presentation. The International Committee of Medical Journal Editors (ICMJE) recommends the following citation style, which is the now nearly universally accepted citation style for scientific papers:
Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.

About the ICMJE and citation styles

The ICMJE is small group of editors of general medical journals who first met informally in Vancouver, British Columbia, in 1978 to establish guidelines for the format of manuscripts submitted to their journals. The group became known as the Vancouver Group. Its requirements for manuscripts, including formats for bibliographic references developed by the U.S. National Library of Medicine (NLM), were first published in 1979. The Vancouver Group expanded and evolved into the International Committee of Medical Journal Editors (ICMJE), which meets annually. The ICMJE created the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.

An alternate version of ICMJE style is to additionally list the month an issue number, but since most journals use continuous pagination, the shorter form provides sufficient information to locate the reference. The NLM now lists all authors.

BCMJ standard citation style is a slight modification of the ICMJE/NLM style, as follows:

  • Only the first three authors are listed, followed by "et al."
  • There is no period after the journal name.
  • Page numbers are not abbreviated.

For more information on the ICMJE Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals, visit

BCMJ Guidelines for Authors

Leave a Reply