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Reimagining the Electronic Health Record


In the article What Will EHRs Look Like in 2020? and my associate’s recent blog on “2020 Hindsight”, both identify the need for systematic change to make the Electronic Health Record a welcome addition to anyone’s practice.

This is meant to be an interactive blog where we will make some suggestions and hopefully others will join in and give their valued opinions.

  • Creating a national healthcare database with the intent of including every individual.

- Such a central database would streamline access to health information for every patient that an Electronic Health Record interacts with. The whole point of interoperability is the ability to easily spread information.

- Direct incentive-type funding (e.g. meaningful use) monies on this common database goal instead of into time and work consuming data collection queries that providers suffer with. With the entire data base available the information can be easily mined to get “Meaningful Use” of all input.

- This would be like putting the money in the bank. Once established, the fundamental resource would be there and available.

  • Create a standardized national Computerized Physician Order Entry (CPOE) system with a user interface replicated at every site care is delivered. Modifiable order sets should be constructed and maintained for every specialty/subspecialty and key presentation.

- This will allow providers of all stripes to interact with various systems without the endless learning curve.

- The entire staff should be able to use the system rather than the highest paid providers being the data input clerks. Hierarchical verification and acknowledgement of orders made and received will promote safety, discussion of clinical course, and appropriate supervision of ordering.

- The orders should be care-setting specific (modular) and provide the most common orders in easy array of choices.

- The pharmacy should also be care-setting specific i.e. Emergency Department, operating room etc.

- Prescriptions/E-prescribing should be care-setting, care-track, and provider specific.

- Simplify. Be sure, for example that calculators (such as pediatric dosing, and other weight/age based therapies, are straightforward and easy to use (see the local ATM)

  • Augment research and application of Artificial Intelligence for clinical decision support

  • - A real potential benefit of an EHR for clinical care is in the promise of AI

- A good system (that functions perhaps as good as an Android monitor of your needs) will be very helpful when employed to generate a differential diagnosis. If the computer recognizes certain symptom complexes, the provider is supplied with easy access to information, treatment protocols, policy recommendations, and appropriate reminders to consider certain diagnostic options.

- Pharmacy alerts that gradate the level of potential severity, should be included

  • Construction of the actual EHR

- Make the nursing notes, provider notes, labs, x-ray reports accessible without having to go to multiple screens. (see Google News)

- Artificial intelligence suggestions should appear in a way that supports the provider’s ability to look over and collate all the data.

- Direct interaction between the EHR and the tracking board tis essential to assist providers and caregivers in controlling a flood of information and prioritizing decision making.

- Built-in Voice Activated Technology to assist the clinical and save time.

  • These are just a few suggestions. Please add your own. Make the record a real-time aid instead of just a billing tool and medical-legal document. Xpress Technologies continues to be on the forefront of technological innovation.

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