Considerations for success (was Re: [Gnumed-devel] FOSS EMR meeting)

[Jim Busser]

On 2010-01-19, at 12:29 PM, Jim Busser wrote:

> I missed the 1st 20 minutes so don't even understand what motivated those 
> distro-people to partake in an IRC chat on EMR ??


That group did seem to want to better understand what people needed. The 
following is from a project spearheaded within my publicly administered 
Vancouver Coastal Health region. It undertook an

        Access to Quality Care Project (2008 - 2010 roughly)

and within it recognized it needed stakeholder input on People,  Process and 
Technology. The feedback on Technology was:

Technology

-       Human interface is key to system navigation, but it can be enabled by 
technology.

-       Systems must be user friendly – they are not viewed as such right now.

-       There are too many technology barriers right now.

-       Providers need to be consulted with regards to system 
design/functionality

-       The value of technology systems must be proved in the context of 
improved clinical care – physicians have ways of accessing information now – 
but it’s often cumbersome and time consuming.  Technology solutions must 
streamline access and eliminate barriers.  Current privacy policies are seen as 
barriers.  Physicians need access to information regardless of where they are 
physically located.  This is especially important when they are on-call. 

-       System integration is important – can’t have duplicate data entry, all 
providers need to work from a common chart/care plan

-       Need to integrate with other tools – depression self-management for 
example, CDM Toolkit, others…

-       Technology solutions must fit within existing workflow.  This is 
essential to adoption and benefits realization.

-       Need a system for managing changes/alerts to the shared care plan

-       Data sharing is essential.  New initiatives must fit within VCH’s IMIS 
strategy. 

-       The majority of information sharing is done manually right now – files 
copied/faxed.  The shared care plan must provide essential information 
when/where required.  The challenge will be determining what is essential.

-       Tools must be built from a variety of perspectives

-       EMRs can be a barrier.  Physicians with patients in residential care 
often can’t access patient files because they’re not authorized or trained to 
use the EMR.  In <the proprietary multi-disciplinary community health system>, 
notations to “see paper chart” are frustrating.

-       Patients have a low level of understanding of electronic health 
records.  This includes how medical information is captured/stored/shared. 

-       There is also limited patient understanding of the various provider 
roles and who should/shouldn’t have access to their information

-       The majority of patients feel the expected benefits of sharing 
information electronically outweigh the perceived privacy risks

-       More patient education and consultation is required.

-- Jim