Archives for July 25, 2009

EMR / Labs call for input

Okay folks, I’m going to call on your wisdom and ask that you help me improve our EMR.

I noticed right after our EMR started, with Rh testing: I would look in past labs to see if my patient (pregnant with vaginal bleeding) had a documented Rh.  Yes, it turns out, many had had more than 5 (even when positive), because we had no way to access those prior tests.  Now we do, with the EMR.

I want to take this a step further, and make a list of tests we can start ‘flagging’ that don’t need to be repeated because some things don’t change.  No sense doing the same thing over and over if the result’s going to be the same.

Here’s my first pass:

  • Rh (if positive)
  • G6PD
  • HIV (if positive)
  • Sickle Cell screens
  • All those heritable clotting disease tests (Factor V Leiden, Protein C, Protein S, etc).

I wouldn’t restrict anyone’s’ ability to re-order (confirmatory test) but would have the prior result pop up in the ordering box for that test.  Usually these are re-ordered in ignorance that it was done before.

Here’s a place an EMR can actually contribute to cost savings!

Please put your recommendations for other tests that don’t need repeating in the comments.  I’ll make a compilation post when other recommendations peter out.

Health Care Rx: The Short Answer Is No – Colleen Conway-Welch

Health Care Rx: The Short Answer Is No – Colleen Conway-Welch
The Short Answer Is No

The short answer is no, not until transformational change occurs in the infrastructure of health care delivery. The system today is so broken that, if the infrastructure is fixed and incentives re-aligned, we could deliver twice the health care to twice the people at half the cost but we won’t achieve this by simply throwing money at it.

Fix healthcare?  Yes!  The author has some good ideas.  Let’s start here, then see where we need to go.