Thursday, October 01, 2009

EHR Bloggers: Disruptive innovation in healthcare

EHR Bloggers: Disruptive innovation in healthcare: "The “job” that physicians need from their EHR is (1) to display all the needed information about the patient-at-hand in order to make medical decisions (which touches on the data-interoperability question discussed above), and (2) help expedite documentation of medical encounters, to result in a high-quality medico-legal record that is effortless to create. There are other workflow “jobs” that physicians in an ambulatory setting also need from their EHR – management of lab results (and the ability to act on them if needed), review of documents as they are received, managing prescriptions and refills, and communicating messages to staff and colleagues.

Medical encounters have some general features that fit into groupings (like diabetes visits, or prenatal visits, or back pain visits), and some elements that are always unique. The challenge for EHR design is to balance these two factors: create flexible templates that facilitate the capture of common items, yet allow for the creation of unique text just as easily. This is critical – in an era where most medical data is still kept on paper, the competition for an EHR is not other EHRs, it is recordkeeping on paper. If it takes longer to create a chart note in an EHR than it does on paper, then there is reluctance to change. The usability of an EHR –how readily does it allow a practitioner to move through the work day and help speed it along – is the lynchpin for adoption. The Practice Fusion approach of flexible, user-modifiable “smart templates” is one example of work-in-progress toward this goal."

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