Finally, the specialized complexity of establishing requirements is challenging. As Koppel explains, even something ostensibly simple, such as blood-pressure measurement, can get dropped in translation because of the modifiers accompanying the figures: standing, sitting, preinjection, labile, noncompliant. So imagine a common vocabulary for MRI reviews or operative notes. Although sector influence is indisputable, such an description conflicts with the impression I got from Judy Faulkner, chief executive officer of EHR maker Epic Systems, who advocates for government-created criteria.By that point I had devised a level that I felt was useful in describing my state of depressive disorder by its symptoms. My psychiatrist may have been familiar with a similar scale that was used by some groups affiliated with the Unhappiness and Bipolar Support Alliance , but she didn’t say so. And my scale was more detailed compared to the DBSA 5-point scale . My psychiatrist found the level very useful in determining my condition of depressive disorder over a period of time. That scale became incorporated in a book I wrote called As well Late in the Afternoon: One Man’s Triumph Over Depression, which can be found at Pyramid Publishers.