What the perfect EMR would look like

EMR software is a data repository for clinicians.  Rather than being just a simple database, what would the ideal software package look like?  What exactly is the perfect electronic medical record?

Every clinician that interacts with the medical record has a specific need.  Whether that is an emergency physician which is looking to track down a specific problem or a family practice physician who is looking to keep track of hundreds of diseases or a nurse who is managing care on a daily basis, each has a specific goal.  With the current vendors, all of these clinicians are exposed to the exact same record.

Would you expose the engineers, accountants, financial managers, project managers, and executives to the exact same information? No, most companies selectively filter their information presenting information that is pertinent.  It’s division of labor.

Without filters, clinicians are presented with extraneous information.  As with any other individual, especially in a time-sensitive, high pressure situation this leads to information overload.  And information overload being an additive process*, this accumulates over time until the point at which the EMR truly gets in the way of accomplishing a task.

Perfect EMR Trait #1: The ideal medical record would be tailored to the specific needs of a clinician, only exposing them to portions of the record which are relevant to their work.

Knowledge within healthcare is rapidly changing.  Possibly more so than another other industry.  Techniques which were considered state-of-the-art, can change in a matter of weeks.  The electronic medical record has the potential to be the tool which disseminates those changes down to the clinician, through point-of-care decision support.  EMR software should facilitate the clinician decision making, rather than requiring clinicians to keep track of the latest and greatest.  This individualistic attitude creates discrepancies in care, which inherently leads to imprecise care.

Perfect EMR Trait #2: The ideal medical record should be able to be extensible, allowing at a minimum changes from research to be disseminated down the clinician level.

Design.  As a single word, its not all that sexy, but when integrated into an experience it becomes indispensable. It’s that feeling you had when making the shift from a PC to a Mac, it’s that “it just works” feeling. In Healthcare IT, some of the most mission critical software, design is consistently lacking.  How do I know this?  No software package should require 36 hours of training.  Period.  That is poorly designed software.

Perfect EMR Trait #3: The ideal medical record should incorporate design and usability principles.  Creating software which is not only useable, but is a joy to use.

By all means, this is not an all-encompassing list.  But if we used this list as a guide we would be a lot closer towards a “meaningful” EMR.

Jonathan Baran is co-founder of HealthFinch.

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