Friday, February 11, 2011

The EMR Limitation

Have you ever done weight watchers? I have and it was fun for a while, but then you start to figure out ways around the rules, the math associated witht he "points", and the limiting factors associated with losing weight – it becomes not fun. For example, why is it motivating to lose my daily points allotment if I lose weight? Isn’t that a punishment? Think about it last week I could have a cookie because I was heavier, but this week after having lost 3 lbs I changed categories (which means your allotted points decrease) means I lost the extra points needed to partake of my favorite treat. 

The other limitation of weight watchers (and frankly any diet) is it’s based on self-reporting. Similar to an EMR if you report incorrectly and cause an error there are consequences – in my case think Bridget Jones – in the second movie.

Yes, Yes, there is an analogy here to Health IT – EMR is dependent on the physical documentation of a clinician, doctor, or other caregiver. There are advances being made to reduce errors such as the automated physiological data capture. There are methodologies by use of Pixis (the Kleenex of the medication world) and other like systems to assist with managing the medication transfer to the unit and barcodes to assist with reducing medication error. There are even RTLS tools that can be used to identify caregiver entry and exit and time frames.  All good things.
There are all sorts of devices, software systems, and technology being created to make things bigger better faster cheaper, but where is the patient in all of this? EMR is a self-reporting tool that allows clinical individuals to document their interactions with patients. But, how are we documenting the Patients interactions with Caregivers.

Why are we painting a picture of the patients stay based on the hospital’s perspective?

What do the patients movements, actions, and requests say about their stay?

Why are we judging a fall risk based on a questionnaire and physical observations?

We are judging caregiver satisfaction by surveys and turnover rate?

Why are we using a survey that’s provided after the patients stay to assess their satisfaction?

What if there is more……what if there were a way to see answers looking at data that is readily available? There is so much information available that provides a clear picture.

The next frontier is not the EMR – the EMR is the current frontier – the next frontier is the patient – the next frontier is the information that the patient is providing to the hospital - physiologically and physically.

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Kourtney Govro