The world’s first commercially sold mobile phone was a 28-ounce, $3,395 Motorola phone, the DynaTAC 8000X, launched in 1983. That’s around $9,000 in today’s money, and more than six times heavier than recently released iPhone 6 which costs as little as $200. The difference of features between the two phones is beyond unbelievable; an undeniable testament of the rapid pace and evolution of technology.
Similarly, looking at the transformation of Electronic Health Records (EHRs), it doesn’t take an Einstein to figure out that they’ve been in the market for far lesser time. They’re getting better by the day, with the industry now flooded with scores of vendors; however, we haven’t seen the DynaTAC 8000X to iPhone 6 evolutions yet.
On the EHR-evolution-scale, we’re somewhere between 1983 and the iPhone 6: somewhere around the year 2005 with a 100-day-year from now onwards. That means that we have decent systems at the moment with massive room for improvement, and we’ll hopefully catch up with the iPhone 6 pretty soon.
However, wouldn’t life be much easier if your EHR was more like your Smartphone? Meeting Meaningful Use and providing better care would be much easier for physicians if their EHR was on their fingertips, much like their usage of the scalpel, don’t you agree?
The main aspect here is functionality, and how physicians could advance patient care and the management of their practice with more intuitive EHRs: ones that offer more functionality for their users.
While these systems have created huge provisions for improving the quality of care, for advancing financial and operational benefits, and for reducing medical errors to name a few benefits, the chief complaint is still that of the time it takes to enter data into the system.
The amount of data entered when a first-time patient walks into a practice begins with his demographic information, progresses to his vitals and problems, followed by the diagnosis, procedure and prescriptions. Entering all this information takes a lot of time, even if you’re delegating your front-desk staff, your nurse and assistant to enter in some of the information.
Similar the “auto-complete word and sentence options” in text messaging for phones of 2014; we need smarter EHRs that recommend options when certain options are selected. What happens with the auto-complete feature is that when you write a specific word, the phone automatically displays options that will likely succeed that word in sentences.
And by auto complete for EHRs, I’m not only referring to, for example; typing “dia”, after which “diabetes” and similar results populate automatically. This is a form of clinical decision support (CDS) which is present in many EHRs, but doctors complain that it is not enough.
If seven times out of ten, patients who visit your practice who come in with a headache also have a stomach pain, for example, wouldn’t it be extremely convenient if the computer automatically recommended stomach pain in additional complaints? Imagine if a list of the generally selected “recommended procedures” and prescriptions for these processes automatically appeared next to their boxes; saving you the inconvenience of typing and identifying each option for everyday cases.
Secondly, even if a provider has managed to enter all this information, many are of the view that this is done more to satisfy Meaningful Use than to actually focus on patient care.
Many doctors including Dr. Jacqueline Fincher, an internist at a small group practice in Thomson, hold similar views.
“The recording of so much extraneous information as part of the clinical record is putting so much garbage in the charts that is not medically relevant and makes the important medical information like a needle in a haystack at times,” she said while talking to GHN.
As the number of visits a patient makes to a practice increase, so does the amount of patient data in the system. Screens get swamped with data, and extracting what you need becomes difficult. Viewing functionality similar to the interface of today’s smartphones, iPads and gadgets could be very helpful here; again only possible with more intelligent EHRs. The technology is there, there’s just the case of more research into the field.
The arrangement of information is crucial here; doctors would prefer important, medically relevant information to pop up as opposed to having everything on the screen or having to drag everything on to the screen.
Next, it is also important for these displays to show intelligence and insight. For example, an intuitive EHR would be expected to automatically populate specific patient information on a follow up visit. Moreover, there would be reminding and notifying pop ups or alerts to remind the doctor if the patient was scheduled, for example; for an x-ray, or for a specific lab if the current blood pressure levels were below a certain level.
This is similar to the mHealth apps which can alert individuals when their vitals are low, or if their prescriptions need refills and so on. When we’re living in an era where iPhone health apps can track insomnia patterns and offer tools to help patients with that and other diseases; it is possible to extend this framework to EHRs, is it not?
Some years back, HTML coding was one heck of a job. You needed to hire a specialist and pay him hefty sums of money to create and maintain your website. Today, with the immense progression of technology you can “go live” on WordPress and similar free open blogging and Content Management Systems from home.
Specialty-specific EHRs are offered by many EHR vendors today, but do any of them offer a truly self-customizable solution? A solution where you had such a simple interface, such as your phone settings, using which you could make any alterations to your system you required. The answer is no.
For most specialty-specific solutions, the vendors edit whatever you think needs editing, create the templates you want them to create, and do your customization for you. Sure they offer drag and drop menus and etc, but ideally, you’d want an EHR which was so simple; you could customize it at will.
The healthcare industry is in a state of constant evolution, and will continue to improve for the better as time progresses. Different EHRs offer different functions and some EHRs may even have their variants of some of the features mentioned above. However, none of the EHRs out there gives you all these options; with functionality as simple and convenient as a cell phone.
The technology there, the minds are there, all we need is someone to take the initiative. EHR vendors are making adjustments, but at a smaller level; more centered towards surviving by meeting government regulations and by enhancing their market share via introducing small changes to their systems. EHRs are becoming intuitive, but they could be made so at a much faster pace. One option is for the government to introduce a cross-country national standard for EHRs which incorporate the best features. With a well thought out plan and a collaborative effort, the investment expenditures on this project could also be kept to a reasonable amount.
About the Author
Alex Tate is a digital marketing specialist, content strategist, and a health IT expert who provides perceptive, engaging and informative content on industry wide topics including EHR, EMR, practice management, revenue cycle management, interoperability, compliance, regulation, and security. Follow me @alextate07
CureMD is the leading provider of Cloud-based EHR, Practice Management and Medical Billing Services to transform the administrative and clinical operations of healthcare organizations of all sizes. Our award winning solutions make decision-making easy, streamline operations and make certain compliance with industry standards and best practices – ultimately saving time and effort to maximize value and returns.