Tuesday, February 15, 2011

Teamwork and the EMR potential

 

Numerous experts discuss the importance of teamwork to an enterprise for efficiency and safety. In healthcare this concept is a relatively new one in the clinical setting. EMR has many potentials and/or shortcomings in this regard and it will depend upon design and user interface optimization to reach it’s maximum potential.

Bob Wachter presents a scenario and back ground for discussing safety culture in medicine, such as the built in hold for surgeons to verbally perform checklists with other staff, such as sideness of surgery, type of surgery, and other important data with the support staff.  These are all designed to minimize or eliminate ‘never events’ like wound infections, wrong side surgery, wrong organ removal, and administration of medications to which  the patient is allergic.

These safety features can be designed into the record with visual graphics, such as an image of the body with a circle or X through the body part to be operated upon. Visual images are processed more readily than printed words, which are often lost in a jumble of letters, even if bold-faced our distinguished by a red color.

Team work can be enhanced by Vector Diagrams or simple block diagrams with participants and specialist each integrated into the overall flow sheet, rather than a list of consultants or tests. Transformation of events and participants should be automatically transferred to such diagrams without human input.

There are many readily appications which perform these actions in other industries and software applications available on the internet, to wit: 

Visual thesaurus: (type in a word)  This application builds a    word map, much as your brain does for many tasks.)  The display is intuitive giving instant meaning to relationships.  This usage of the application could easily be adapted to professional resources and the team for each patient in a hospital setting. For very ill patients with multiple system issues this can be very complicated. The Virtual Consult Manager ferrets out key relationships easily seen by all participants in the team. Each segment can display as much or as little of the information in that segment. The circles can be clickable and take one straight to the relevant data for each team member.

The Map can be structured in a hierarchal, chronologic, spider, cluster or other organizational aids.

There are SDK for development of the map for other industries that interface with languages inherent in EMR, such as XML, CSS,

A few examples:

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Now imagine these images as dynamic and fluid with changes in relationships. The user would be able to ‘pull out’ each button to see further breakdowns in organization, plans, and treatments. 

You can trial this at Visual Thesaurus

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