Time To Rethink EMR Design And User Interface

There’s a great new article in the March 2012 issue of The American Journal for Managed Care, “IT-Enabled Systems Engineering Approach to Monitoring and Reducing ADEs.” You can find it here. The point I’m trying to make in this blog, by drawing attention to this article, is this: it’s time for EMR vendors to rethink the fundamental design and user interface of their products.

They’ve been basically unchanged for 10 years at least, supporting the same concept of encounter-based care that itself goes back at least 50 years. EMR vendors need to stop thinking of patient care as short-term encounters with a clinician and start thinking of patient care as long-term project management with a team of care providers. EMR user interfaces need to look more like a project management tool that enables social collaboration, task assignment and follow-up, and the collective wisdom of the care team, including the patient’s wisdom, more effectively.

In summary, the AJMC article concludes that by using Web-enabled team resource management (TRM) tools, clinical work teams can significantly reduce the rate of adverse drug events (ADEs) in patient care. According to the article, “the rate of ADEs decreased from 25.8 to 18.3 per 100 patients per year in the intervention group. The rate was virtually unchanged in the control group (24.3 vs. 24.8).” That’s a major impact.

The study described in the article is particularly impressive in that the TRM tool leveraged the collective wisdom of the care team in identifying, tracking, and measuring the causes and interventions associated with ADEs. It’s a prospective model for preventing ADEs versus a retrospective root cause and failure modes analysis of what caused the ADE. Very, very impressive approach. The team at the Department of Family Medicine and UB School of Management, State University of New York at Buffalo should be widely acknowledged for this innovative yet common-sense approach to patient care.

EMR vendors, please take note.

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Editor’s Note: In addition to his role as senior technology advisor and CIO Mentor for the Cayman Islands Health Services Authority, Dale Sanders is also senior vice president at Healthcare Quality Catalyst and senior research fellow for The Advisory Board Company.