EHR on Wheels

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Matt King

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Jan 1, 2022, 4:09:38 PM1/1/22
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 I wonder how many of us remember going to the airport with carry-on luggage before they put wheels on them? What a pain it was! Then one day I went to the airport and everyone had wheels on their carry-on luggage. There were no advertisements, slide shows, or fights over whether or not wheels were better. Everyone knew wheels were better. I quickly bought hand luggage with wheels.


The front-line staff have opinions about which EHR is best; but if you ask them generally, if they like EHRs, the answer is no. It’s because the amount of time they need to invest in using an EHR isn’t worth the value it creates for them. It creates great value for the business office and the administrative staff, but only marginal value for the front-line staff. And it really slows them down.


I wonder if we stopped thinking about the problem in terms of Cerner versus VistA, and instead looked into the future to imagine an EHR so compelling, you wouldn’t need to sell it, because everyone would understand it is superior.


When I look into the future, it see a lot of technology that already exists, but is not integrated into modern EHRs. I see AI tools that could help clinicians with both diagnosis and treatment. I see HIEs that can be bring the complete patient picture onto one screen. I see wearables that can send exception notifications when one occurs. I see this system connected to pharmacy, where a recommended lab test could be given with results sent directly through the Smart phone, wearable or pharmacy lab. Think of a clinician having data points from many locations and patient experiences, not just 15 minutes in the exam room. Think of the exam room as everywhere, not in a scheduled time slot in some building.


The system would be designed to reduce the number of physician visits, and improve diagnosis and treatment. This should create value not only to front-line staff, but the actual patient, too.


The idea here is that we shouldn’t be spending money on another suitcase with no wheels, because then we won’t have money for the wheels. We should be spending money on building the wheels.


What do you see when you think of your EHR on wheels?


m

Nancy Anthracite

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Jan 1, 2022, 4:46:44 PM1/1/22
to hard...@googlegroups.com, Matt King

I see Matt pulling it and flying right by everybody else!

 

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Nancy Anthracite

Wolfgang Giere

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Jan 1, 2022, 5:56:08 PM1/1/22
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Excuse me, Matt, but what is HIE. Google says 'Neonatal hypoxic ischemic encephalopathy' but that does not fit into the context.

 

;-(

 

Wolfgang

 

BTW.: Happy New Year!

 

 

 

 

 

-----Original-Nachricht-----

Betreff: [Hardhats] EHR on Wheels

Datum: 2022-01-01T22:09:42+0100

Von: "Matt King" <flyd...@gmail.com>

An: "Hardhats" <hard...@googlegroups.com>

 

 

 

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Wolfgang Giere

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Jan 1, 2022, 6:11:17 PM1/1/22
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Matt, if I think on 'EHRs on wheels' (I like your description) I see what I call an 'active' EHR which knows the patient AND the special interest profile of the user (physician, nurse, technician) and augments patient data with every info that is relevant for the patient problem and new for the user. (She or he can indicate how often news shal be repeated.) It isn't anymore a technical problem, but exists only as (forgotten?) prototype, as far as I can see.

 

Btw. That is what BAIK was intending and the idea behind the transatlantic cooperation in the NSF/EU project MuchMore.

 

Wolfgang

 

 

 

-----Original-Nachricht-----

Betreff: [Hardhats] EHR on Wheels

Datum: 2022-01-01T22:09:42+0100

Von: "Matt King" <flyd...@gmail.com>

An: "Hardhats" <hard...@googlegroups.com>

 

 

 

 I wonder how many of us remember going to the airport with carry-on luggage before they put wheels on them? What a pain it was! Then one day I went to the airport and everyone had wheels on their carry-on luggage. There were no advertisements, slide shows, or fights over whether or not wheels were better. Everyone knew wheels were better. I quickly bought hand luggage with wheels.

--


Nancy Anthracite

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Jan 1, 2022, 6:45:08 PM1/1/22
to hard...@googlegroups.com, Wolfgang Giere

Health Information Exchange(s) Personally, I think they are fine if you want them to exchange your information, but here in the states, patients' information gets loaded into them whether they give permission or not and then patients have much less control over who gets to see their personal information than I think there should be. Most states, if not all, have them. Then there is PCORI (https://www.pcori.org/), which takes the information as well, and CMS that takes it in the form of quality measure reporting, etc., etc.

 

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Nancy Anthracite

Jim St. Clair

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Jan 1, 2022, 7:00:26 PM1/1/22
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instead looked into the future to imagine an EHR so compelling, you wouldn’t need to sell it, because everyone would understand it is superior...”
I’d suggest looking to a future where the EHR is a back-end system and patient engagement is driven synchronously and asynchronously through a CRM type system. 
To use the analogy, it’s how your flight app knows what gate to send you, allows to change seats, advises of delays and tracks your luggage.

Best Regards,

Jim St.Clair

Executive Director

Linux Foundation Public Health

(228) 273-4893

www.lfph.io

Connect with me: https://calendly.com/jstclair-4



From: Wolfgang Giere <W.G...@t-online.de>
Sent: Saturday, January 1, 2022 5:11:02 PM
To: hard...@googlegroups.com <hard...@googlegroups.com>
Subject: AW: [Hardhats] EHR on Wheels
 

Matt King

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Jan 1, 2022, 7:03:25 PM1/1/22
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Health Information Exchange. All states have them and all health facilities are supposed to exchange information in an approved format, for instance, CCDA. So if my patient received a Covid shot at Walgreens Pharmacy, visited an urgent care, and was admitted to the hospital across town, I can access all that information with just one connection. The trick is bringing it into the EHR it a way that makes it easy for the clinician to view the relevant documents in the proper context. Here at Central Regional Hospital, we have some ideas about how to do that and hope to build it this year, starting in January, as a matter of fact.

Happy New Year, Wolfgang.

m

Jim St. Clair

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Jan 1, 2022, 7:03:25 PM1/1/22
to hard...@googlegroups.com, Wolfgang Giere
HIEs vary widely from state to state as to whether thay have any role in retaining or moving patient data based on the laws of the state they’re in. 

Best Regards,

Jim St.Clair

Executive Director

Linux Foundation Public Health

(228) 273-4893

www.lfph.io

Connect with me: https://calendly.com/jstclair-4



From: hard...@googlegroups.com <hard...@googlegroups.com> on behalf of Nancy Anthracite <nanth...@earthlink.net>
Sent: Saturday, January 1, 2022 5:45:02 PM
To: hard...@googlegroups.com <hard...@googlegroups.com>
Cc: Wolfgang Giere <W.G...@t-online.de>
Subject: Re: AW: [Hardhats] EHR on Wheels
 
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Wolfgang Giere

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Jan 2, 2022, 4:13:38 AM1/2/22
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Thank you Nancy and Matt -- so HIE is a nightmare for German "Datenschützer", officials (state employde and required by law in any company with more than xxx employees) who try to preserve privacy of data.

 

Wolfgang

 

 

 

-----Original-Nachricht-----

Betreff: Re: [Hardhats] EHR on Wheels

Datum: 2022-01-02T01:03:28+0100

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