Viewpoint: EMRs are a 'platform for innovation and creativity'

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Rather than waiting for vendors to make EMR add-ons commercially available, leading hospitals have increasingly begun to integrate their own improvements into the products, two officials from Seattle-based Virginia Mason Medical Center wrote in an op-ed published in Harvard Business Review Oct. 10.

"Just as the cell phone, originally designed as a mobile communication device, has been adapted to an unimagined array of additional functions, the EMR is serving as a platform for innovation and creativity," wrote A. James Bender, MD, medical director for clinical informatics, and Robert S. Mecklenburg, MD, medical director of the Center for Health Care Solutions.

A few key innovations Dr. Bender and Dr. Mecklenburg have witnessed in EMRs include the addition of detailed prompts and reminders to help providers standardize care and sharing medical information to engage patients and their families in holding providers accountable for their care. For the authors, "mistake-proofing" also proves one powerful benefit of the EMR.

In 2004, Virginia Mason Medical Center officials helped Seattle employers identify their most costly conditions from data housed in EMRs. They discovered primary cost drivers included unnecessary MRI or CT scans and used these findings to create a computerized checklist for evidence-based ordering.

"If the ordering provider could not specify an evidence-based rationale for the test, the computer blocked the order," the authors wrote. "The result: As we 'mistake-proofed' provider orders, advanced imaging for these conditions dropped 25 percent."

To continue to drive these types of innovations, the authors suggested hospital leaders establish best-practices standards and partner with vendors to embed protocols into EMRs.

"Providers that embrace the full functionality of the EMR will have an advantage in gaining market share and in lowering their costs," the authors concluded. "The best doctors will use the EMR to add the deep knowledge and protection of digital mistake-proofing to the art of medicine that they bring to each of their patients."

To access the full article, click here.

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