When a doctor tells you what features they believe need to be in an EMR, it’s worth a listen. And when that doctor has personally managed the ongoing development of their own EMR, I find their ideas to be even more interesting.
Such informed recommendations are just what Hayward Zwerling, MD, has to offer. Zwerling is a practicing physician, and also the creator of the ComChart ambulatory EMR, which he launched in 1990 and kept on the market until 2015. Zwerling recently published a list of features which, he argues, should be in virtually every EMR. Below, here’s a sampling of his suggestions:
- Provide a button displaying all abnormal lab results, and make the resulting list sortable by test name, test date or any other available parameter.
- Allow the physician to display any subset of the patient’s lab results, and offer an option to omit individual results and resort the displayed data. Also, allow doctors to export the data in cvs or Excel format.
- Permit doctors to create lab test charts on the fly, including any combination of tests from the patient’s existing lab work. In addition, make it possible to incorporate this chart into a Progress Note approved up to chart for the patient.
- Make it easy for the doctor to create an association between incoming test results and specific medicines. (For example, if a cholesterol test result appears, include the name of any statin the patient currently takes.) And make it possible to create lab charts which include concurrent medication information, with just one click.
- Clearly display who ordered a test and to whom a copy of the test was distributed.
- Allow physicians to create test result charts from within the Progress Notes section.
- Permit physicians to add selected free text from the Progress Notes to the problem list, medicine list, allergy list, family history or old problem list by highlighting the data and clicking a single button.
- Create a free text field on the Progress Note layout allowing doctors to enter information that is not an official part of the patient’s chart. For example, the clinician might write a note such as “Daughter wants issue of her mother’s depression to be discussed at the mother’s next visit, and daughter does not want to be identified.”
- Allow doctors to search free text Progress Notes for a word or phrase. Also, make it possible to search some or all of the entire EMR’s free text Progress Notes in this matter.
Zwerling goes on at much greater length in his post on The Health Care Blog, so much so that his suggestions spill over into a separate blog entry. But this subset of suggestions make the point on their own. He clearly believes — quite reasonably — that doctors should have access to simple, easy-to-understand tools when they use EMRs, and that there should be no need to refer to a manual or attend training classes.
He sums it up thusly: “The feature should be presented to the user in a manner which make it intuitively obvious how to utilize the feature.” Really, don’t we all agree with him? And if so, why are so few EMRs organized this way?