Natalie Hodge MD posted an interesting list on Quora of what she considers a strong EMR system:
I am a pediatrician. Here is what I must have in 2011.
1. Usability. When I say usability, I mean I decide the definition of usability.
2. Patient Health Record. nuf said.
3. Lab interfaces that help my patients get convenient and timely blood draws that flow directly into their medical record.
4. Eprescriber that is easy to use and hosted within the same platform so I don’t have to worry about a third parties server being slow.
5. Secure messaging.
a. I need to be able to email patients in a secure fashion, and they need to be able to email me.
b. Text. I need to have secure text messaging visits with patients.
c. Video. I need to be able to do video visits with patients at times.
d. I need to be able to communicate with my team securely.
6. Inbound fax that brings any external communication directly into my emr system. Seriously it’s 2011.
7. Ecommerce. I do membership practice so I can’t be running to the bank all day long depositing checks.
8. Web based. I have to work in a web based world, because I don’t like the expense of maintaining servers and I have to be able to access my data from anywhere.
9. Iteration. I have to have a rapid feedback loop with the developers of the application. If I can’t continually give feedback that makes the emr better, then I may as well go buy an old dell desktop computer from 2004 and start using that.
10. Mobile. I must be able to access all of this on my mobile, right now, I’m Iphone 4 but next week I might be android.
11. Open. The EMR must continually create further opportunities to help physicians manage health of their patients, whether it’s by integrations with loseit.com, imoveyou.com or nike training camp’s iphone ap. Self tracking may be a key tool physicians may use to solving our nation’s health crisis.
So what I am saying is I have to be able to function in an entirely paperless loop, despite the distractions of reform, medicaid, medicare, meaningful use, and payors.
I’m sure many will have a lot to say about this list. Here are a few of my comments:
1. I wonder how Dr. Hodge defines usable. Of course, that’s the problem. She wants it usable, but likely can’t really define it.
5. I love a number of these ideas. Just a few HIPAA/security issues to deal with. Back in March 2006 I wrote a post with the idea of just having the full video recording from a visit in the EMR. I think it’s the long term future of healthcare. It is interesting that in many companies they want more video recording to protect them from liability. In other cases like many in healthcare, they don’t want video recording since it adds to their liability. I’ll be interested to see EMR vendors text message strategies going forward.
7. You don’t like the checks? Imagine that. Online bill pay. Amazing!
9. This is INCREDIBLY INCREDIBLY valuable. It’s one of the reasons why a smaller, but stable EHR vendor is often more desirable than one of the big name EHR vendors.
What do you think about this list? Is it reasonable? What’s it missing?