The History of, and predictions for, Electronic Medical Records
The question of whether or not to use Electronic Medical Records (EMRs) has been answered, the question now is what will the next generation of EMRs bring? Many thought that EMRs would bring about a revolutionary change to medical records, but the reality is much more boring. Current EMRs only mirror the old paper records which have existed since the 20’s.
Duct Tape Solutions
Current models are built upon a network which was developed in the 60’s. This old system is riddled with errors which, instead of scrapping and creating a new and better system, developers are simply attempting to fix by slapping a new feature on it. This is what is referred to as a duct tape solution. Rather than correct the profound structural issue, a temporary solution is used. This is done because of the potential cost involved in replacing the old system.
Both physicians and patients have difficult in navigating the current system. The sad reality is that many social media platforms provide far more usability and access to information than current EMRs. These problems can be addressed by having EMR vendors integrate around a collaborative connectivity hub. These hubs, like the nurses sheet, will provide better access to information for all parties. When the health of the patients are concerned, there is simply too much at stake for hospitals to maintain these legacy system.
Medical Scribes Are Not the Answer
One issue of particular concern is the use of medical scribes. There is little question that requiring physicians to enter large amounts of information into EMRs will cut down on their productivity and reduce patient contact time. Due to this reality, physicians employ medical scribes to enter data for them.
This unnecessary step will increase the cost of healthcare and reduce the original premise that EMRs would increase physician efficiency. A better designed system would allow physicians to customize their documentation to the workflow that works for them. This will help reduce on unnecessary costs and lower the cost of healthcare.
EMR Scavenger Hunts
The ability to connect with a single interface would improve day-to-day patient care and create a standard for where EMR information is stored. Using the current system, one must look in multiple places within the EMR in order to gather all of the relevant pieces of information. This current method is much like a scavenger hunt and reduces the quality of the patients care.
The old problems of paper-based medical charts are still here. Tools were simply developed to overcome their limitations, making them more readable but still containing all of the inherent flaws in the system. Forcing users to switch locations to view information relevant to a patients care will continue to prevent real advances in EMR technology.
Lack of Communication
A medical record is simply a log of patient data which has been annotated by the physicians and other healthcare practitioners. This means that above all other functions, the medical record is a way for physicians to communicate with one another to the benefit of the patient. While the current EMRs still serves this purpose while improving oversight and error detection, the communication capability does not go far beyond that of paper.
A user of the EMR must still search through information. If they are unable to find information, they have no way of knowing whether or not that information was discarded, missing or never entered. This issue frequently results in duplication and medical errors. In current EMRs, it is often not clear when a piece of information has been reviewed and acted upon. Future EMRs must address this problem.
“Smart” Hub Collaborative Data Needed
A system is needed that will align medical professionals with the data that they need. This needs to be a collaborative effort, not a passive one, which includes analysis. This will also allow the correct data to be delivered to the correct practitioners. This hub would include target notification, universal access from anywhere at any time, and open architecture for future innovation. Such a system would make the data “smart” through a collaborative platform that can analyze and interpret the data.
Perfection is not expected on the first iteration of such a grand endeavor, rather only progress is expected. Imagine a future where early adoptors are able to customize or even develop tools to streamline their EMRs. This future would allow for much more innovation and, ultimately, benefit the patient.
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