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A List Of Must-Have EMR Features

Posted on July 28, 2016 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

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:

Lab features:

  • 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.

Progress Notes:

  • 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?

Meaningful Use Program a Success…Depending on How You Measure Success

Posted on January 22, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

The new National Coordinator of Health IT, Karen Desalvo, MD, published a blog post on The Health Care blog that proclaims that the “EHR Incentive Program Is on Track.” Of course, many would argue that it’s her job to be a cheerleader for healthcare IT, but I think this post is an important look at the measures that ONC and HHS have of what they consider a success.

If the goal of the EHR incentive money is just to get doctors and hospitals using EHR software, then indeed it’s been a big success. EHR adoption is through the roof at every level (although, I think they’d like it higher in the ambulatory space). This can’t be argued. The $36 billion in EHR incentive money got healthcare on board with EHR software.

If EHR use is your measure of success, then the HITECH act was a success. However, the goal of the HITECH act wasn’t just EHR adoption. If it was, then we wouldn’t have meaningful use. The goal was for doctors to adopt an EHR and then meaningfully use it. Of course, the jury is still out on whether doctors will follow through on meaningful use stage 2. I’m personally predicting a major fall out from those who attested to MU stage 1 and those that choose to sit out MU stage 2. Certainly Dr. Desalvo argues that this won’t be the case.

Either way, let’s assume that the majority of doctors do attest to meaningful use stage 2. Should we call the HITECH act a success? More pointedly, does meaningful use produce the results we want?

As someone who follows the EHR industry day in and day out, I think the jury’s still out on this. I’ve said many times that I fear the EHR incentive money might have incentivized doctors to adopt the wrong EHR software. The current and future EHR switching will likely prove this out. Although, we’ll see if organizations can get it right the second time.

However, choosing the right EHR is only half of the battle. Even the best tool used inappropriately won’t yield the desired results. There’s a strong case to make that meaningful use forces a doctor to use an EHR inappropriately. Every person at ONC calls this blasphemous and every doctor is likely to agree that meaningful use causes more work and does little to improve care.

I recently heard someone argue that they had “no sympathy for doctors having to accurately, legibly, and cohesively document what is happening.” I think it’s a real challenge to say that meaningful use equates the more accurate, legible, and cohesive documentation. In fact, many of the meaningful use hoops serve to make the documentation more illegible and difficult to read. Not to mention the issue of making the physician less efficient and therefore more likely to cut corners.

In this post, I’m not trying to make the case for or against EHR software. I’ve done a whole series on the benefits of EHR and so I believe that they can provide an amazing benefit to healthcare when implemented properly. My point with this post is that if our government is going to spend $36 billion on EHR software, then I wish they’d spend a little more time making sure that it’s not only implemented, but implemented well.

If they did this, then maybe we could call the HITECH act a real success. As it stands now, we’re using the only metrics we have available: EHR incentive spent and meaningful use attestation. I’d suggest there’s so much more value (both gained and lost) in an EHR implementation than either of those two things measures.

How about we track ways EHR use reduced costs, improved patient care, and saved lives? Maybe they don’t want to track that data because if they do, they won’t like the results. What would they do with meaningful use if they found out it raised costs, hurt patient care and did nothing to save lives? Would anyone want to make the case for why meaningful use should be scraped for something better? I wouldn’t want to as the new ONC chair either.

A Few EMR and Healthcare IT Blog Recommendations

Posted on November 22, 2010 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

As you know on the weekend, I try to do my simple posts since most of you are enjoying the weekend like you should.

Today I thought it might be interesting to point to a few different EMR and healthcare IT blog recommendations. This is far from an inclusive list. In fact, I could probably do this every weekend and not repeat the same blog recommendations. Maybe I will! Especially since then as I read various other blogs I can remember to make note of it. So, for this post I’ll start with some popular ones that many people know about.

Fierce EMR – I really like the work that Neil Versel does and Fierce is lucky to have him working on their EMR content.

HIStalk – This is often a bit too hospital focused for my tastes. They do have HIStalk Practice which is more ambulatory focused and has gotten better as Inga’s focused on it more.

Chilmark Research – I really enjoy John’s blog. He does a good job analyzing HIE, EHR and mobile healthcare. The only complaint is that he doesn’t publish enough, but that’s ok. When he does publish it’s almost always an interesting read.

The Health Care Blog – My only complaint about The Health Care blog is that often times it has a lot of posts that aren’t related to health care IT. Although, it does have a strong group of health care IT bloggers that do some great IT and EMR related posts.

Like I said, there are dozens and dozens of other ones. These are a few of the ones that have been around for quite a while doing their thing. I’ll cover some more of the other blogs I enjoy next time. Or you could just keep reading this site and my other blogs (EMR and EHR & The Wired EMR Practice) where I try to write about a lot of the major happenings in the EMR and healthcare IT world.