Em...Urrr...

I''m usually up for some casual reading on the subject of Electronic Medical Records. I emphasize the casual; I'm not looking deeply at it, because a) I'm not very good with details unless I work at it, and b) I don't do this for a living - it's just an interest of mine. The current writing in Musings of a Distractible Mind suit that bill (and this Bill!) because there's detail, but not a lot of it. It's more an overview, with thoughts.

He makes the case that implementation of an EMR is not impossible, and that it can be done without impact to the functioning of a practice provided it is done carefully, with an eye toward function rather than implementation : "Probably the main lesson we learned is to put office function ahead of implementation. Since we are a business, we must stay profitable while implementing. Since we are practicing medicine, we must never compromise quality in the process. This meant that we implemented over time, focusing on parts that would either improve our process or at least not bring us down." This is a detail that processes which are driven by software types tend to miss. We like software; we can't imagine that there isn't anything wrong with a process that can't be fixed by the application of mo'bettah software. (Dilbert: "We like databases.") Business types struggled for a very long time to tame this attitude, and subject software to the needs of the business. They're stilll fighting that battle today; likely always will.

Having successfully implemented, though, he now finds his multi-doc practice in an interesting area - they can begin to daydream what else could be done with EMRs. He wants to do two things -- improve the quality of customer care (sorry; I have this thing about calling the people who bring in the business as 'patients') while maintaining or expanding the efficiency of the business. He wonders, for example, if he can expand the access of the customers to digital information, letting them update some of it as needed, passing others to staff or doctors for information and/or resolution. Could he have kiosks in the waiting room where people can, if they wish, write down their medical condition, answering some common diagnostic questions along the way (I immediately think: artificial intelligence?) so that the doctor can scan these prior to entering the examination room, and be already thinking about them.

It's an interesting article.