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Better, Safer Care: Imagining a Medical Record of the Future

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Better, Safer Care: Imagining a Medical Record of the Future

By Luke Sato, MD and Tom A. Augello, CRICO

Related to: Ambulatory, Communication, Documentation, Electronic Health Records, Emergency Medicine, Primary Care, Nursing, Obstetrics, Other Specialties, Surgery

Shouldn’t we all strive for a better clinical experience?

Everyone who works in a clinical setting, or has ever been treated in one, probably has an opinion about Electronic Medical Records (EMRs). Physicians complain about alert fatigue, lack of standards across systems, and a need for too much manual entry.  Patients complain about competing for their doctor’s attention during an exam due to time spent on the computer.

Is it futurstic, or isn’t it? Our film presents an alternate vision for a streamlined and integrated clinical experience; one where physician, patient, and EMR work as a team to provide a significantly automated, safer, and efficient experience. However, most of the technical solutions presented in this film are currently available. So why, for example, don’t all EMRs use voice recognition software for automated dictation of patient encounters?

Film elicits broad range of emotional reactions from clinical audience.

As the patient safety and medical malpractice insurance company for the Harvard system, CRICO has based our dramatization on real malpractice cases. Through combined analysis of how harm can come to patients from flawed encounters with providers and conversations with medical and technological visionaries across the country, we integrated various scenarios into an idealized patient/physician encounter.

Doctors and nurses face growing challenges that a workflow oriented electronic medical record can help solve: information overload, production pressure, administrative requirements, and increasingly short time seeing each patient. They need a solution that will anticipate a logical and standardized workflow; prompt for referrals, prescriptions, and lab tests, then automatically populate the record and generate reminders.

Consider the possiblities.

The patient safety risks we address in our film include: inadequate history-taking, failure to evaluate symptoms, missed test results, and poor patient-doctor interactions. Our data shows these to be common contributing factors to medical malpractice claims. Traditional EMRs, evolved from hospital billing systems, provide a wealth of information and data, but fall short of helping clinicians streamline significant administrative requirements or process the vast amounts of information needed to care for patients. Nor do they reduce risk by helping avoid the types of oversights that can lead to an adverse event.

Our head-on approach to these issues has elicited a range of emotional reactions from those who view the film. As more medical sites utilizing EMRs, how can we provide a clear vision so people don’t get lost in the “implementation weeds?” How can we move from a data-repository model, to one that truly helps clinicians improve their workflow?

We hope to prompt conversation and initiate action by health care leaders poised to implement change. Ideas abound. We know ours is not the only answer.

Watch our film, then share your reactions.

What are other people saying about EMRs?


November 5, 2012
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