On my post from a few days ago, Tim wrote a thoughtful comment that caused me to respond that doctors are often not involved enough in EMR design. My first EMR that ended up crashing and burning was a complete disaster and had clear evidence of lacking this essential physician component. How do I know this, you might ask?
Well, the previous EMR required entry of ICD-9 codes for your family in order to “take” a family history. In other words, if a patient’s mother had hypertension, you needed to enter 401.1 into her blanks, and so on. Since no doctor is going to know all these codes off the top of his or her head, this could not have involved a real doctor in the decision to create such an unorthodox and cumbersome approach to charting.
My second EMR that I love, Practice Fusion, had its origin in what Dr. Robert Rowley was already doing a long time ago in his Family Practice clinic. From what I’ve been told, he was programming a rudimentary version of what now exists. A software engineer further developed this into the first version of PF, and this EMR system makes good sense in how data is entered and displayed. The templates that I program allow me maximal flexibility to build the chart note however works easiest and best for me.
It really seems to be true that proper design by the right people working together can make a world of difference in the end user’s experience.
Dr. West is an endocrinologist in private practice in Washington, DC. He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC, as a solo practice in 2009. He can be reached at doctorwestindc@gmail.com.
