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The EMR Language

Posted on February 4, 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.

If you haven’t read this insightfully candid post by Rob Lamberts, MD, you should go check it out now. Here’s the opening which should get you intrigued:

OK, I’ll admit it: I had no idea. I thought that the whining and griping by other doctors about EMR was just petulance by a group of people who like to be in charge and who resist change. I thought that they were struggling because of their lack of insight into the real benefits of digital records, instead focusing on their insignificant immediate needs. I thought they were a bunch of dopes.

Yep. I am a jerk.

My transition to a new practice gave me the opportunity to dump my old EMR (with all the deficiencies I’ve come to hate) and get a new, more current system.* I figured that someone like me would be able to learn and master a new EMR with ease. After all, I do understand about data schema, structured and unstructured data, I know about MEDCIN, SNOMED, and HL-7 interfaces. Gosh darn it, I am a card-carrying member of the EMR elite! A new product should be a piece of cake! I’ll put my credentials at the bottom of this post, in case you are interested.**

So, imagine my shock when I was confused and befuddled as I attempted to learn this new product. How could someone who could claim a bunch of product enhancements as my personal suggestions have any problem with a different system? The insight into the answer to this sheds light onto one of the basic problems with EMR systems.

Since he said it, I had to take a look at his “credentials” to provide some perspective on the post as well:

  • I did my residency at Indiana University, the land where Clem McDonald, one of the pioneers of electronic records made our records electronic when personal computers were still new (I attended from 1990 to 1994). It was there I became a believer in computerized records.
  • In practice, I installed MedicaLogic’s EMR in 1996, as one of the first users of their Windows based product, Logician.
  • Within 2 years I was on the user group board, and was elected president in 1998. I was a regular speaker at the conferences and known for my profuse production of clinical content (called “Encounter Forms”)
  • In 2003, I applied for and won the HIMSS Davies Award for ambulatory care for our practice, recognizing our achievements with EMR in an ambulatory setting.
  • After that, I served on several committees for HIMSS, gave talks for multiple other groups (NHQA, National Governors Association), giving the keynote talks for the HIMSS series given around the country to convince docs to adopt EMR.
  • In 2011, I participated in a CDC Public Health Grand Rounds as a speaker from the physician perspective on the subject of Electronic Medical Records and “Meaningful Use.”

Finally, he ends with the money quote, “So to those I have scorned in the past, I bow my head in shame. I got good at using a complex tool that allowed me to manage the insanity of our system. It turns out that my skill was a very narrow one.

There are so many fascinating things about this post. Many of which we’ve discussed many times before here at EMR and HIPAA. The first one that I want to highlight is the idea that EMRs were developed around our insane payment system as opposed to around amazing patient care. Long time readers might remember my starry eyed dreaming about what an EMR would look like if it didn’t have to worry about billing. Sadly this isn’t the state of EMR software and likely won’t be in the near future. However, it is the biggest challenge that an EMR vendor faces.

Dr. Lamberts is right that there are good and bad parts of every EMR system. No EMR system is perfect. Instead, each one does certain things really well and certain things subpar. This is a feature of pretty much every software. When an EMR system doesn’t do something well it could be because they just haven’t had time to optimize it. Although, more often, their are subtle development issues which make changing an EMR workflow very difficult. Not to mention the impact of a subtle workflow change to your existing EHR users.

Thinking back to Dr. Lamberts post, he talks about how he’d become an expert on the intricacies of his EMR software. If his EMR vendor were to change that workflow to a more optimized one, he would have revolted. Maybe the new workflow is better, but the fact that he knew the old workflow has value as well and changing it has its own costs. Thus the challenge to updating any EMR software.

No EMR is perfect. Choose the EMR whose challenges you don’t mind dealing with on a daily basis.

Another message I get from Dr. Lamberts post is not to give too much value to awards, groups, and industry committees. Not that I really did before anyway. I’ve always been a take it with a grain of salt kind of guy.

Five More Pregnancy Apps for Moms-To-Be By Mobile Mom

Posted on I Written By

Katie Clark is originally from Colorado and currently lives in Utah with her husband and son. She writes primarily for Smart Phone Health Care, but contributes to several Health Care Scene blogs, including EMR Thoughts, EMR and EHR, and EMR and HIPAA. She enjoys learning about Health IT and mHealth, and finding ways to improve her own health along the way.

Last year, I wrote about must have pregnancy apps for moms-to-be. Recently, I’ve come across a suite of pregnancy apps that I want to add to the must have list.

Mobile Mom — the company behind these apps — aims to put “pregnancy info on your mobile device — anytime, anywhere.” And after downloading and looking at the apps, they basically have everything covered from pre-conception to pregnancy. These are the six apps that can be downloaded:

  • Ovulation Calendar

    This app helps a woman track which days she is most fertile and likely to conceive. It actually gives the six  most fertile days during a month, as well as for the next several months. One feature I liked was that it tells you when the baby’s due date is, if you happened to conceive during that time. Since it gives you dates for about five months, it is a nice visual and good for planning.

  • Pregnancy Test

    No, this isn’t an actual pregnancy test. I don’t think anyone would want to use it if it was. However, if a woman suspects she is pregnant, this app asks several questions pertaining to common early-pregnancy symptoms. After the questions are asked, the app generates the likelihood that a woman is pregnant. I’ve seen similar “quizzes” online, so it’s not totally new, but it looks interested. Obviously, there’s more certain ways to know if you are pregnant, but in those early days where a positive pregnancy test may not show up, it might be nice to have. Though, I’d hate to get my hopes up from this app saying I was probably pregnant, only to have it not be true!

  • Due Date Calculator

    Once a pregnancy is confirmed, this app tells you when your estimate due date is, how long you’ve been pregnant, likely conception date, and when a particular trimester will end. It’s pretty simple. You can also put in your due date, and it will calculate backwards this information.

  • Weight Gain Calculator

    This is probably most women’s least favorite thing to talk about during pregnancy, but it is important to make sure weight gain isn’t too little or too much. I had a website that I went to weekly where I put my weight in and it told me if I was gaining too little, too much, or just the right amount, which I really liked. Having it as a mobile app would have been nice though, because it was just more convenient.

  • Baby Names

    Pretty explanatory, this app just has a big database of baby names. I recommend having something like this on your phone, just for those times when you have some extra time to look at names. It sure beats carrying around one of those big baby name books! This app has more search options than a lot of the apps I’ve used and seen, especially since it is free. You can search by boy or girl names, or by more unique searches, like by a specific initial or meaning.

  • Pregnancy Talk

    This app actually hasn’t been released yet, but I think it would the app I’d be most likely to use. Even though it’s been almost a year since my son was born, I frequent the message boards on BabyCenter.com, just to connect with other moms going through the same things I am. From what I can tell, this app will have a similar function.

To be honest, I feel like some of these apps could have been condensed into one — mainly the first three. I’m not a big fan of downloading an app if it has very few functions, and would be far more likely to download one with those first three feature combined into one. Obviously, most of these apps aren’t really new ideas, but they are well-designed, and if you want all your pregnancy apps to be from the same maker…these aren’t a bad option at all. Some of them have some unique features, which makes them stand out from other apps. I think the fact that all of these are free are the most attractive part of these apps, because many times, the best pregnancy

For the iOS apps, go here

For the Android apps, go here