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Fixing EMR Drawbacks

Posted on October 17, 2011 I Written By

Priya Ramachandran is a Maryland based freelance writer. In a former life, she wrote software code and managed Sarbanes Oxley related audits for IT departments. She now enjoys writing about healthcare, science and technology.

FierceHealthIT editor Ken Terry had a recent post on the need for better human-computer interfaces in EMRs. He highlighted a few areas where EMRs could stand some improvement, and I thought they were bang on. These are aspects I’ve thought about a great deal myself, and true to the Steve Jobs dictum of staying foolish, I’m offering some solutions to these oft-mentioned problems. I’m sure there are plenty of people who have already thought of these and better solutions, but here we go:

1) Initial Data Entry – The biggest headache for providers’ offices today is what to do with all those boxes of medical records. Scanning solutions exist but they leave you with unstructured data. Manual extraction is time-consuming and requires upfront investment. I’ve pondered for a while about this. I think on-demand data extraction might be the way to go. Provider offices know ahead of time what their weekly, even monthly appointments are. If a provider’s office digitizes the records of patients with upcoming appointments every week, it should have most of its records digitized by end of year. This is assuming patients make it to the doctor’s office for at least once-a-year appointments if not more. If the office outsources this work, it needs some monetary investment, no doubt, but such a setup might be affordable since it is pay-as-you-go.

2) Templating – Terry states that many doctors hate the templates that come with most EMRs. And templates make it easy to generate pages and pages of verbiage which say exactly the same thing for patients with similar profiles, or say very little that is meaningful. Surely customizable or extensible templates can get rid of this problem. Or speech-to-text dictation that allows the doctor to mirror practices from not so long ago.

3) Alert Overload – Many EMRs are designed to issue alerts for adverse drug interactions, prompts for patients and similar such decision support tools. But too few of these and you risk not asking the right questions. Too many providers just ignore them, or worse, override them. No easy solutions for this one, except maybe to figure out where the fine line lies between lack of decision support and too many alerts.

4) Interoperability – EMRs cannot talk to each other. So a patient who moves from one provider to another is really at the mercy of software whimsies. Or worse. For providers, it’s equally frustrating not to be able to get ahold of the patient records in a format suitable for their particular EMR software. One simple answer – standards. Granted HL7 is still evolving, but EMR vendors need to at least consider offering data exports in this format.

Steve Jobs and Healthcare IT – EMR

Posted on October 7, 2011 I Written By

John Lynn is the Founder of the blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of and John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I like I’m sure many of you have been a bit overwhelmed by the amazing outpouring of love that’s happened after the passing of Steve Jobs. It was weird for me, because I knew that Steve Jobs health wasn’t good but I was still a bit shocked to see on Twitter that he’d passed away. Certainly a major loss for his family, but the effect will be felt well beyond them.

I’ve been touched by a number of posts throughout the healthcare IT and EMR blogosphere. Here’s a roundup of a few of the Steve Jobs posts I found.

Jim Tate did a post that considers what if Steve Jobs had developed an EHR. Here’s one section:

For the past 5 years I’ve kept hoping that Apple would develop an EHR. One that when someone first used it they would say: “Yes, this is how it should be”. Whatever he developed and released to the world didn’t even need an owner’s manual. It just worked in a very human way.

I know I’ve written about the possible Apple EHR as well and what it might look like. As I read Jim’s post I couldn’t help but wonder if the reason Steve Jobs didn’t take on a project like an EHR was because our regulations and reimbursement don’t work in a human way.

Dr. Liu on Kevin MD wrote a post about Steve Jobs as a physician mentor. I love the idea that Steve Jobs was his mentor even though they never met. He offered this heartfelt thought:

I as a doctor I’m incredibly sorry that medicine has not yet evolved to the point that a cure exists for the rare type of cancer Jobs. I’m sorry that he is so ill at an incredibly young age, in his mid 50s, when many people begin to contribute even more to society with all of the knowledge and experience they’ve acquired. The future might be a little less bright without Jobs leading his team at Apple on creating products and experiences none of us truly knew existed until he showed them to us.

It is such a shame that he died so young. In fact, I’d say that might be the hardest part of it all.

The self professed Mac Fan boy, John Moore from Chilmark research, paid a tribute as well. He highlights some of the key things that Steve Jobs did with Apple products:
-Design aesthetics combined with functionality rule
-Supporting a renegade
-Systems rather than parts
-Supporting innovation

Yep, Steve Jobs will be missed in healthcare and well beyond.