These slides review problems with current electronic medical record (EMR) systems and makes suggestions for future improvements in design and usability. This work was sponsored by the Szollosi Healthcare Innovation Program (www.TheSHIPHome.org).

1. Improving EMRs Problems with Current EMRs Thoughts on Future EMRs April, 2009 Lyle Berkowitz, MD, FHIMSS Program Director, Szollosi Healthcare Innovation Program ( www.TheSHIPHome.org ) Email: [email_address] Web: www.DrLyle.com

5. What will the Future look like?

7. The Current 3-Tier Monopoly of EMR Vendors “ Get those vendors to separate their data from their application .” – Dr. William Stead (Jan, 2009) Data Storage Application Processing User Interface

8. Separating The Data from the Applications The Data “Platform” Physician Workflow Tools Data Storage Application Processing User Interface Application Processing Application Processing Application Processing Application Processing Application Processing Application Processing Application Processing Application Processing User Interface User Interface User Interface User Interface User Interface User Interface User Interface

9. Another way to look at it Multiple Care Settings Single Care Setting EHR EMR PWT EMR PWT PWT PWT

11. New Ways to Look at Information

12. Problem List: Current View

13. Problem List – Future View #1

14. Problem List – Future View #2

15. Problem List – Future View #3

16. A New Way to Look at Results

17. A New Way to Look at Results

18. Context-Sensitive Screens and Widgets

19. Problem Details

20. Problem Details

21. Med Refill Widget

23. Future: 5-15 years Transform the Computer From a machine that simply responds to your actions To the best assistant you ever had

24. “ Patient-centered cognitive support” The authors said the “overarching, grand research challenge” of the computer science research community is developing “ patient-centered cognitive support .” Computer systems need to build virtual models of a patient’s status, models that depict and simulate a theory about interactions going on in the patient similar to those models going on in the head of a physician working unaided by a computer. - NRC Report (Jan, 2009)

25. A robot that understands…

26. Current EMR Workflow Patient and EMR wait for Physician Physician does all data review and input

27. Future EMR Workflow EMR gathers data, creates documentation and suggests a plan Physician reviews and edits EMR summary and plan

28. Potential Time Savings Physician then has more time to spend with patient for tough diagnostic analyses, education, etc…

29. This presentation was sponsored by… www.TheSHIPHome.org

31. Thoughts on Innovation Innovation is a systemic process that draws insights and ideas from inter-disciplinary groups… in a conscious, purposeful search for innovation opportunities . - Peter Drucker The oldest habit in the world for resisting change is to complain that unless the remedy to the disease should be universally applied, it should not be applied at all. But you must start somewhere. -Winston Churchill Don’t tell me what you can’t do. - Peter Szollosi