Transcript SmartEMR

SMART EMR
Diabetes Demo
FOR DYNAMIC DEMO
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CAVEAT:
This is not a functional EMR, but an interface prototype
that is intended to demonstrate concepts only.
Single Management Console Reconfigured with Context
This interface is a prototype suggesting how dynamic reconfiguration based on clinical context could provide
cognitive gains, better status and management tools, all readily at hand. This may make best practices easier to
achieve, and provide more patient relationship time, gained from data hunting time.
STATIC present-generation EMRs
Tables of categorized data
All health conditions together
Cognitive work of building a
mental model when seeing a
patient for a specific concern
is intensive
For example, dealing with
diabetes in a 72yr old with
other co-morbidities
A SMARTER way
On the left, static table of conditions
On the right, an interactive and graphical
icon that:
- shows the condition on roll-over
- engages knowledge engines to
configure the EMR for the
condition chosen – presentations,
anticipated actions, resources, all
at hand
Diabetes is in this mannequin located on
the pedestal
Context-dependent Reminder Menus
The Smart EMR can utilize reminders which are gateways to schedules,
actions, resources – these can be varied by the EMR for the clinical
context
In this example, the Patient is at the Medical Home, and these are general
reminders which can vary based on known conditions (if not smoker, don’t
put SMOKING in) and demographics –
In moving to Diabetes Management, these would be tailored for important
reminders for diabetes, such as ACE/ARB prescription
Diabetes - Tailored and Organized Information
Health conditions shown are
now restricted to those
relevant to diabetes
Tests shown are now restricted
to those relevant to diabetes
and its co-morbidities eg high
BP
Trends important in assessing
current status are prepared
and displayed ready for
physician analysis
REMINDERS are customizable
active links to elements of
Care Pathways that apply to
this patient with specific status
indicators
The mannequin is persistent,
so that navigation to Patient
Home, or other conditions, are
always present
Diabetes-specific Management
The Reminders have now been generated by the EMR to be specific to this
patient’s diabetic status…
To engage in management decisions, the ENCOUNTERs circled in red will bring
up an example of what might be a Management Console
Diabetes Management Console
The area in yellow shows
the most recent diabetes
quality indicators, including
medications.
The Show Alerts toggle can
remind the physician (or not)
of actions that are due,
according to guidelines…as
shown for Foot exam in red
By selecting the brown area
across from the measures,
labs can be ordered,
medications changed or
renewed, right from
here…without having to
duplicate these actions in
“Prescriptions” or “Referrals”
The SOAP notes permit
physician annotations.
Diabetes – Resources
Reminders can be
configured to provide
actions, or documents, or
analyses
In the SMART
knowledge-based system,
these Reminders can be
configured dynamically
In this example, the
Diabetes Rx in red will
bring up the Guideline
table of diabetic
medications. If it’s there, it
might be used.
Management Console Potential
As it is important to know
whether the diabetic
status has been stable,
or changing, preparing a
graph showing the
HgA1c over time should
be done by the Smart
EMR
Clicking on the HgA1c
button will then display
the graph, without having
to go into the Lab
module to graph this test.
Management Console Potential
As it is important to know
whether the diabetic
status has been stable,
or changing, preparing
the trend of BPs can be
prepared and ready to
show.
Clicking on the BP button
will then display the data
without having to do
multiple clicks to achieve
an important function.
Conclusion
Smart EMRs could:
Reduce cognitive burden
Show what is relevant
Prepare analyses and trends ready to display
Organize and structure information and actions
specific to a patient’s clinical status
Enable and converge care to best practices
Shift time used to chase information to relationship time