As a technology evangelist in the Electronic Health Record (EHR) field, I believe that we are obligated to provide software that healthcare providers want to use because it helps them improve outcomes and provides them with an enjoyable user experience. I believe that above and beyond the incentives provided by the HITECH Act that as an industry we owe it to our users to provide a user experience that makes them not just compliant, but happy to use our systems because they add value and improve outcomes. Capturing structured data and integrating with other systems can best achieve these goals.
Healthcare providers should have an EHR system that improves their daily professional lives. The EHR system should facilitate a provider’s interactions with patients by giving the provider and their patients context sensitive information about the patients’ medical conditions that both helps prevent medical errors and educates the patient. The EHR system should simplify repetitive tasks like creating visit notes, preparing standard forms and providing written post care instructions for patients. The EHR system should capture and send data in a structured format accessible through a clinical vocabulary so that the data can be used to benefit the people that entered it.
These are more than just abstract principles for me; they are a design philosophy. As a contributor to Modernizing Medicine’s Electronic Medical Assistant® (EMA™) I have helped turn this design philosophy into a reality.
EMA’s touch-based user interface, adaptive learning and built-in medical knowledge provide the user with a better and faster tool than paper charts. Instead of asking users to spend long hours up front building templates that quickly become outdated or are a chore to maintain, EMA adapts to the way providers practice as they use it. Instead of asking users to type or dictate lengthy notes, EMA constructs the note based on a few touches and the way that the provider has used a diagnosis or performed a procedure in the past.
EMA users report that they are able to spend less time working with the EHR system and pay more attention to their patients. When you combine the way the user interacts with EMA with the medical domain information, alert system, integrations and other features EMA provides, users start to see a strong incentive to work with EMA to capture structured data.
EMA was designed from the outset to capture information as structured data. EMA was also designed from the start so that capturing structured data wouldn’t slow the provider down. Users regularly report that EMA helps them go faster and that is by design.
All of these benefits have provided EMA users with the incentive to enter millions of visit notes since EMA first became commercially available around August 2010. EMA users will be the first beneficiaries of the structured data that they have entered. In the summer of 2013, we formally introduced EMA Grand Rounds™ and EMA Outcomes™ to the EMA Network™. EMA Grand Rounds allows a user to see what they prescribe most often for a diagnosis and compare that with what users in their practice prescribe as well as what users in the entire EMA network prescribe. This allows providers to see what other EMA users use for treating rare diseases that they don’t see often as well as for common diseases when their primary and secondary treatments have failed.
EMA Outcomes leverages the structured data that the providers have entered to track the progress of a disease or condition at a glance. Where in the past a provider might have to flip through a series of paper charts or review text based electronic notes, with EMA Outcomes the user can visualize trends, treatments and outcomes over time at a glance.
In addition to the benefits that structured data can provide, I believe that healthcare providers should have an EHR system that integrates well with other systems that handle the exchange of records among providers, universities and hospitals, public health organizations, electronic prescription networks, electronic lab networks and so on.
The HITECH Act pushes the healthcare IT industry in the direction of structured data and better integrations between systems. If vendors of all types of healthcare IT systems work together to build a system that includes the ability to quickly and conveniently exchange structured data, then I believe that we can provide users with timely access to the information they need to improve outcomes. That’s good for everyone.