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Can EMR make us better doctors? Harnessing the power of EMR to improve patient outcomes

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Ever wonder if your treatments are really working for your patients? If you are like most clinicians, it can be difficult to tell because we don’t consistently track standardized outcomes in every one of our patients. However, linking treatment data with patient outcomes in a real-world practice setting can be highly valuable. Doing so allows us to learn from our own experiences and may even enable us to make better clinical decisions in the future. In my 15 years of clinical research experience, I have seen many different types of research studies that help advance clinical care. However, none is more exciting than the power of real-world data to inform care decisions. During the past few years, the electronic medical record (EMR) systems have changed the way we record and exchange patient clinical information. As clinicians, we want our EMR system to help us to become more efficient. But, can EMR systems even make us better doctors? Each day, as we input information on our patients into the EMR system – their vital signs, medications, clinical progress or laboratory values –  this information has the potential to uncover trends in patient responses and lead to new discoveries. That is, information entered into an EMR system in our usual clinical care has the potential to help us figure out if our treatments really work for our patients. How does that happen? Imagine a patient with pemphigus foliaceus walks into your office and asks for your help. You realize that the last time you saw this rare disease was during residency when a patient with pemphigus foliaceus was presented at grand rounds by your overachieving co-resident. You also realize that you do not recall the first–line treatment for this rare disease. After going through several physician medical resource sites, you are frustrated because it was difficult to locate any relevant information that will help you to manage this patient now. What you would like is point-of-care decision support that will help you with the patient in front of you. Now, imagine you can call on the experience of over 2,000 colleagues in an instant. While this might be your first patient with pemphigus foliaceous, the combined number of patients with pemphigus foliaceous cared for by the 2,000 other dermatologists using the same EMR system is 500. Now, imagine you can view the first-line, second-line and third-line treatments for these patients with one click. In addition, you are able to see how patients’ responses vary depending on these treatments. This real-world data based on the most up-to-date and collective wisdom of modern-day physicians can guide your approach towards the patient in front of you now. Imagine you have now cared for your pemphigus foliaceous patient for 3 years. You wanted to see how the patient’s response tracked over time and which treatments worked and which didn’t. You are delighted to learn that your EMR system can plot a patient’s outcome over time and show you along this outcome time continuum the various points the patient used and changed therapies. This type of longitudinal data is invaluable as you decide how well your specific treatments have worked for this patient. By leveraging the collective wisdom of our colleagues, we can consider other therapeutic options that had not occurred to us before. By entering structured data on validated outcomes on our patients, we can track how well they have responded to our treatments over time and make smarter decisions based on our own data. Now, we are making the EMR system work for us! Ultimately, the very act of recording structured and relevant information into the EMR system during the normal course of clinical care can help make us better doctors. How cool would that be?

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The Author

April Armstrong
MD, MPH, Director of Clinical Data and Outcomes