In the last post, we discussed sharing the data entry experience with patients while engaging them in their healthcare. Today, The Medical Strategist highlights an important issue that is very succinctly written by David Lareau, the CEO of Medicomp Systems.  The issue is that of “bringing data back to the patient”.


In time, it certainly appears that the government will require integration of all care providers across the spectrum to not only report, but to improve patient outcomes at the point of care. This of course, will require documentation by all users and all settings to be interoperable and connected. There are a number of steps that EHR developers and providers need to consider and take to get to move closer to providing patient-centric care.

  1. Integration and expansion of all users. While many physicians are on EHRs and sharing data with physicians in their network, the care isn’t coordinated across the enterprise or with other users. Namely, with the nurses, who are responsible for administering the care based on the clinician’s diagnosis and orders. Until recently, nursing protocols were not available for documentation. They are today and as they come online and available in more EHRs, clinically coordinated healthcare is no longer going to be the exception, but will rapidly become the norm. The efficiencies and accuracy achieved as a result will make it impossible for providers who don’t use technology to coordinate care to compete. Protocols for ancillary caregivers and therapists will also be integrated into EHRs so that the entire care team can use the EHR to document and share information in real time. This will facilitate communications between doctors, nurses and therapists, improving efficiency and accuracy.
  2. Integration of all settings. Until we can communicate across the enterprise and ambulatory settings, the clinician really isn’t able to get a clear picture of the patient nor is care expedited or comprehensive. The capability exists to do this today and the efficiencies that stand to be gained from unifying ambulatory and enterprise setting are huge. Not only are the foreseeable meaningful use requirements a motivator to unify all settings, but the cost savings and competitive edge should be as well. Think of how this could improve communications, reporting accuracy and of course, patient care.
  3. Accurate, timely documentation that meets all requirements. In addition to ensuring that all users and settings are using technology to share information and document patient encounters, providers and developer need to ensure that documentation is accurate and meets all requirements. Think about it this way, if information isn’t coded accurately and quickly, then errors get moved along to the next clinician. And given that the clinician needs information in real time at the point of care, it’s really imperative that documentation occurs in real time on the spot. If the enterprise hasn’t employed an EHR that takes care of documentation at the point of care, then now is the time to consider upgrading or adding a tool that will take care of documentation, of course, without burdening the clinician.
  4. Interoperability. EHRs have to, sooner than later, talk with other EHRs outside of their network. Open-ended design software is critical to flexibility and adaptability. Very seldom do patients stay within one network nor do they stay at home or in one location. Healthcare has to be mobile along with their medical records. It’s becoming increasingly important to not just be able to network stateside, but globally as well.

Why can’t EMRs be like EMail? 

When you log on to your computer to get your email, it is accessible from anywhere there is online service.  It does not matter whether you are using an IBM PC or a MAC.  It doesn’t matter what server you are using like Safari or Firefox.  You log in, put your user name and password in and VOilA! Your email is there.

But why isn’t it just that simple with communications between electronic health record systems?  Simple- $$$$

As soon as the mandate and financial incentive appeared for adoption of medical record implementation, hundreds of vendors popped up- each with their own system.  The idea of making a system that would interface with others was not a priority.  Indeed, if it could be accessed with other systems, maybe they would lose their clients to other systems!  Meaningful use adoption is slow because it has to undo what greed has cast asunder.  It could have been very simple- if we were prepared for it.

What have your experiences been?  Has it been difficult for you?  Share your stories in the comment box below.