Electronic Medical Records

Today Medpundit gives the latest update in her FP offices’ quest to ‘go paperless’. It’s sobering reading.

Dr. Smythe (pseudonym) there has an upbeat attitude, but is very clear that the changeover is stressing the staff out. It’s good to read.

And it brings up my current gripe with EMR, especially as it relates to EM. To my (limited) knowledge most of the EMR’s out there are just glorified word processors. There’s nothing wrong with word processors, except that they slow practices down, not speed them up.

Additionally, the programming isn’t terribly advanced. Things in the HPI need to trigger automatic exams, etc. Abnormal lab results need to be adressed, and at least suggested in the diagnosis box.

I’m very interested in MedPundit’s trials and tribulations on this issue, and look forward to her next post.


  1. The ED I formerly worked for is implementing a very interesting ED management system/EMR that is different from some I’ve seen. It’s from a company called PCTS, a product called Amelior ED. It has some interesting built-in AI/Reference stuff, or at least was billed as such.

    For instance, assuming it’s set up correctly, it could suggest that since the patient has both otitis media and a UTI and is not allergic to sulfa that Bactrim might be a good choice of antibiotic, even though that might not be my first choice for either.

    Well, so-freaking-what, you might rightfully ask, I can do the same thing in my head in a fraction of a second, it’s called “being a doctor”. Ah, you are correct. But what if an ED is having a problem getting all the docs to recognize that Keflex vs. the currently rampant skin staph is comparable to Woody Allen vs. George Foreman, then you might begin to see where such “suggestions” could be beneficial.

    Another example they gave in the demo is that it allegedly has very robust set of reference material built in so that when confronted with something very uncommon, like a retinal artery hemorrhage, the software could suggest therapy and provide reference material to support the suggestions.

    Does this all work?

    How dad-gum much up front work is involved in making it work?

    Will it speed up the ED?

    I think the jury’s certainly still out, but this was one of the more exciting demo’s of medical software I’d seen, and I’ve seen a lot.

    We’ll see how it goes, as I think their implementation begins within the next couple of months.

  2. Craig,
    Please do keep me informed.

    And, it’s a small world. I was one of the docs at Ameliors’ first beta test site. It’s the only EMR I have worked with, and I agree it has a lot of fascinating possibilities. I particularly enjoyed the physician order entry, with orders immediately being sent to the nurses, the lab, etc, though it comes with a downside: you’re the only one looking at all the orders, so the clerk doesn’t get to help you out (didn’t you want a beta? = saves another hour wait).

    I thought it slowed me down a huge amount, but I think any of the systems would do that. I’m sure now they have the big bugs worked out (holy cow), and that you’ll just have the regular teething pains of a switch.

    Again, please let me know how it goes!