By Bill Peckham
Existing Electronic Medical Record systems (EMRs) can be improved by changing the way staff access the screen they need.
Currently EMRs speed users to a screen tailored to a procedure for a given patient with as few clicks as possible. After typing a few letters of a patient's last name, the EMRs user can select the screen of interest from a drop down list, a physician rounding will have their list of billable procedures, a technician will have theirs. This process should be slowed down a beat by putting the procedure links below information specific to the individual, information curated by the individual or on the individual's behalf.
A 21st Century Vision for Electronic Medical Record systems
EMRs will be tailored by/for an individual to tell medical staff what the individual in their role as patient would like them to know; what the individual in their role as a Medicare beneficiary would like them to know; and what the individual and their primary care physician(s) believe are important metrics.
Examples. Want medical staff to know:
- this picture of me surrounded by my 23 nieces and nephews
- I prefer Mrs. Jones not Sue or Susan and certainly not Suzie.
- Do not use my right arm for blood pressures, I have a 28 year old fistula I am very proud of
- I know my treatment options, including transplant, I use conventional incenter dialysis by choice. I'm on the TX list
Goals for care; goals due to care:
- I want a kidney transplant
- I want to visit 50 countries, I've gotten to 35.
- I want to be there for my spouse, she is frail so I need to be well.
- I enjoy living in my home and tending my garden. I've had some neighbors for over 30 years
Metrics deemed important, including patient reported outcomes via mobile app:
- Blood pressure during dialysis (from unit EMRs)
- Blood pressure at home (from app)
- Number of hours of dialysis in the week (from unit EMRs)
- number of hours worked in the week (from app)
- 30 minutes of walking/daily (from app)
- "How do you feel?" (from app)
Links to the screens staff use to best do their work, will be right below information that staff can use to best provide care.
Modern EMRs should explain the patient to staff, at the point of treatment, in the context of goals set by patient and physician working together. A little Facebook-isation can accomplish this and more by greatly improving the experience and value of healthcare. EMRs should provide the right information at the right time so that in a world of checkboxes and timed interactions staff can see the person who is in the role of their patient