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Rethinking medical records: Visual EMR idea

I’m a resident physician in primary care and have used Epic, Cerner, Greenway, Meditech, Allscripts, CPRS, and here’s what I’ve learned: they’re all based on paper charting systems, and they all increase time in charting while offering minimal improvement in chart review efficiency. I haven’t used Open-EMR beyond the online demo, but from what I can see, it likely lies somewhere between these systems in visual aesthetics, functionality, and operability.

I have been considering mechanisms for improvement for some time, and thought this community might be a good place to test the waters on an idea: the “visual EMR”.

“Notes” are archaic, and one of the reasons documentation takes so long is the repetition built into each note creation, as well as note review. I’d like to see a “visit” based system that’s also “visual” . In this system, the patient care timeline would be the centerpiece, not the notes.

A mockup is below. As opposed to clinic notes now, which so often are a weird balance of point-and-click requirement-fillers and then long auto-populated rehashings of medication and problem lists, this format would help emphasize updating of problem lists, association of medications to disease, and streamlining of chart review. Likely could integrate preventive care better too.

So, for the Open-EMR community’s consideration:

  1. Would this be better for clinicians?
  2. Do EMR companies care enough about their clinician interface to adopt something like this? Or could Open-EMR do it?
  3. What drawbacks do you see?
  4. Is it ACTUALLY different than how we do things now, or just dressed up differently?

Look forward to any thoughts/comments!

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