It's time to re-open the debate over templating vs. free text in EMR documentation. For this, we turn to Canada.
Dr. Ravi Murthy, a family physician in the Toronto area, wanted to improve record-keeping and efficiency while also maintaining some of his personal autonomy because his staff was prone to constant turnover; but he didn't like most of the EMRs on the market. So through his own company, GoHomeDoc, Murthy built his own EMR and is now bringing Promise EMR to market in the province of Ontario with the promise that it can save doctors two to three hours a day.
Murthy and his development team put more than 2,000 customizable templates in the system to cover the most common problems that general practitioners see. Rather than asking questions to arrive at a diagnosis, Promise EMR lets physicians make the diagnosis first, then create notes to document the case. Technology for Doctors, a publication affiliated with Canadian Healthcare Technology magazine, reports that documentation takes seconds instead of minutes, as users simply need to click a mouse or speak commands to complete this task, no typing necessary.
"I can simultaneously do charting while maintaining eye contact with the patient, giving them my full attention," Murthy tells Technology for Doctors. "Improving communication by this method is very reassuring to the patient, which I can't do if I don't look at them."
The EMR contains HL7 interfaces for easy importation of lab data, and also features e-prescribing, patient scheduling and a billing system. Physicians can enter care plans so they know the goal of subsequent patient visits.
Left unsaid is whether the diagnosis-first strategy prevents the incorporation of clinical decision support. If so, this product likely wouldn't ever earn certification in the U.S. because "meaningful use" will require CDS.
For more information:
- take a look at this Technology for Doctors story