Transcript Open SmartEMR Works

OPEN SMARTEMR
WORKS
Ernie Chang
ejhcmd@gmail
.com
A NEW KIND OF EMR
Knowledge of
clinical
relationships
in data
elements
Convenient ata-glance
interface to
status and
actions
Smart
EMR
Not just
passive
data
elements
Not just a
search and
retrieval
engine
Not just an
SQL
database
A Knowledge Assistant
Reasoning
ability for
Best
Practices and
Guidelines
SMARTEMR
Dynamic Presentation
• Configures on-screen clinical information,
reminders, actions using clinical status and
guidelines
Clinical Guidelines
• Informs reminders, tasks, care plans and patient
actions
Clinical Context
• Determines relevant data, knowledge relationships
and guideline application
A Knowledge Assistant
that preselects data and
Guidelines, generates
recommendations and
lays out the Interface
FUNDAMENTALS
At-A-Glance Interface for status and actions
Presentation at user-interface is tailored and dynamic
Easy for user to build mental model of patient
Guidelines tailored by Clinical Context and Status
Data filtered and organized into Clinical Status
Clinical Context drives the encounter
CLINICAL CONTEXTS
Diabetes
Asthma
COPD
Osteoarthritis
Stroke
Sore throat
Urinary tract
infection
Depression
Low Back
Pain
etc
etc
DIABETES CLINICAL CONTEXT
•Presentation manager
•Dynamic layout for
presentation of status and
actions to be taken
•Optimize for ease of access
•Zero-click for status
•One-click for most actions
•Lab & other tests,
medications, consults,
imaging, reports from
patient and other
•Trends, graphs, and
summaries to be
generated for presentation
•Includes possible medication
changes, schedule of visits,
possible tests, referrals,
patient self-management
education and tools needed
•Generates access to
resources
Generates
interface
Generates
recommen
dations
Filters and
organizes
data
Customize
Diabetes
guideline
See: www.10screens.com
If the patient has HgA1c < 8, the
recommendations for HgA1c >8
clearly don’t apply and can be put
aside for this clinical encounter
userid: [email protected]
Pwd: guest
SMARTEMR – ACHIEVABLE?
Very hard
Very useful
At-A-Glance
Filtered and
Organized
Information
Knowledge and
Reasoning
Clinical context
and status
SQL data
Loads of Data
Usefulness vs Amount of presentation needed
Complexity vs new effort needed
STRATEGIES FOR ADVANCING
•Instead of requiring each EMR to
provide these capabilities, an
alternate approach is to define a
Standard Interface
Common
Interface for
EMRs
•Implement in layers
•Data layer for elements and entities
•Information layer that relates eg
metformin to diabetes
•Knowledge layer that can parse
guidelines and care plans
•Presentation manager that can
dynamically manage screen real estate
for competing demands from knowledge
agents
•This would provide a means of
mapping the elements needed in
SmartEMR to the SQL access
methods of a specific EMR system
•The EMR vendor would provide the
access methods for data elements
needed by SmartEMR
Implement
in Layers
and small
steps
Open Public
Domain Approach
– many shared
efforts
TO PARTICIPATE
 Contact: Ernie Chang at [email protected]
 Take the 10screens.com demo and share it with others
 Create your own Clinical Context demos
 Share ideas on how to move ahead – small steps, grand plans
 Believe it is achievable, and computing power is almost
infinite, and knowledge engines, definitions and ontologies in
health care are almost within reach