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Where’s the Imagery in EHR?

Posted on July 26, 2013 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.

One of my readers recently asked me, “Where’s the imagery in EHR?”

It was a fascinating question. At the core of their question was the implication that there was real value in images that wasn’t being leveraged in EHR software. This is not to say that EHR software doesn’t do any imagery, but it could do so much more. Pretty much every EHR software I’ve seen has some sort of image documentation available. Sometimes it’s just uploading an image to the EHR, but in most cases you can incorporate an image into the documentation itself. Usually you can do some sort of Paint like editing of the image as well. Although, that’s about the extent of imagery in most EHR software.

Of course, when most people hear imagery and EHR, they likely think of DICOM images from radiology. This is definitely missing from most EHR software as well. The excuse is usually a mix of the DICOM images being too large and having the right software to view the DICOM images. With that said, I think this imagery will eventually be part of the images available in an EHR.

I’d love to see much more imagery available in the EHR. It should be as simple to add a photo into your EHR as it is to post it to instagram. We’re not there yet, but we should be. There are hundreds of situations in healthcare where an image provides incredible benefit to your documentation. Imagine having images or video from the Otoscope stored in the EMR. The technology is there to be able to store this type of imagery in an EHR. In fact, back in 2006 I predicted that one day an EMR would store a video recording of an entire patient visit.

Why don’t we see more imagery in EMR?

The simple reason we don’t see more imagery in EMR is that reimbursement doesn’t require it. In fact, you could make a case that reimbursement discourages the use of imagery in documentation. The same goes for physician liability. You can make a case that more imagery in an EHR can make for more physician liability. Unfortunately, healthcare is heavily influenced by both reimbursement and liability.

Meaningful use doesn’t do anything to encourage the use of imagery as well. In fact, the healthcare interoperability standards do almost nothing to consider the transfer of image based documentation. They basically didn’t take this into account, because so little documentation includes it.

There are a few EMR vendors that are taking imagery seriously. Modernizing Medicine’s EMA EMR is one example. They use images to document the whole visit. Although, ironically they take all this amazing image work and translate it into text because that’s what’s required for reimbursement. How twisted is that? Of course, the EMA EMR is designed for specialties that really benefit from images: dermatology, opthamology, optometry, plastic surgery, and orthopedics.

I’d love to see more imagery used in EMR. Unfortunately, I see nothing driving the use of images in EMR.

Super Bowl Power, Video EMR, EMR Data Standards, and EMR Spend

Posted on February 3, 2013 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.


In case you missed the Super Bowl, the power went out for a good 30-45 minutes. It’s the EMR’s fault. We could create a whole comedy routine blaming a hospital’s problems on the EMR I think.


I’ve talked about video in EMR for about 7 years. The problem is we don’t have a great way to pull the data out of the video. Plus, I’m sure there will be many that resist the idea of a video recording of their patient visits. I still see it happening one day soon. I wonder if HealthSpot will be doing this in their kiosks.


Who should be creating the structured data standards? I’d like doctors themselves doing it, but they’re too busy (or so most of them say).


I wonder when this spending will stop. At the end of meaningful use?

Video EMR

Posted on March 18, 2011 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.

Back in March 2006, I had this great idea about synchronizing video with the EMR. Essentially instead of having to do all these pick lists of information, you’d just record the whole visit with the doctor and that would be all the documentation you’d need. Ok, so that won’t quite work, because you need some things recorded granularly, but the idea of a video EMR was and is really interesting.

Thus, you can imagine my interest when I saw this article about a company, CareCam, that’s developing a video based EMR. Here’s a quote from the article:

CareCam is developing an EMR system based on video. The idea came to founder and president Shannon Pierce from her days working as a nurse. Data entry distracts clinicians from patient care, she said.

But the based in Greenville, S,C.-based company’s 2009 patent on the method of documenting health records describes the technology as an electronic documentation system consisting of “documentation devices having a digital video recorder directed towards the patient.”

The device will record video and audio information about the care of the patient, categorizing the data and logging it for future reference. That would be a different tack from most EMR offerings on the market, which aim to move paper records to the digital world, but without the audio and video that CareCam proposes.

EMR may eventually replace paper records altogether, but doctors, and likely their patients, will ultimately decide whether a video record is preferable to other formats. CareCam completed its first pilot in December, according to Pierce.

As I look at their website, there’s not much information. However, it seems to me more like the cameras are for virtual office visits and not for recording visits in the doctor’s office like it described in the quote above. Of course, these type of video cam visits from home are a popular topic and I can definitely see them becoming very popular. Especially as more and more devices start coming built in with a camera like the iPad (the iPad 2 has 2 cameras).

I’m still really intrigued by the idea of integrating an EMR with video. Video is becoming more and more popular on the web and I can see integrating video into an EMR being a very interesting next step. Most EMR systems can actually support some video today. I can easily see a dermatologist taking a video of a person’s skin and uploading it to the EMR. There wouldn’t be the seamless playback that would make it really cool, but it’s certainly possible today. Hardest part today is getting it off the camera and into the EMR. A nice iPad or smart phone app could easily solve that problem.

Looks like I should have patented my video EMR idea back in 2006.