Chris Netherton, M.D.

Electronic Patient Records help doctors deliver the right type of care

Work by two doctors in the USA has demonstrated how electronic patient records can help avoid costly mistakes in the way that medical care is provided.

In a fascinating article this month in Harvard Business Review, two American doctors talk in detail about their experience with electronic patient records. James Bender MD and Robert Mecklenburg MD are both based at the Virginia Mason Medical Centre in Seattle.

While these doctors recognise that the adoption of electronic patient records has been a real challenge for the profession, their experience has shown that there is “no question” that this technology has led to important improvements in patient safety, care delivery and care accuracy. However, they also highlight a crucial area where they believe that electronic patient records are not yet being used to their full potential – and that lies in the avoidance of unnecessary or inappropriate care.

They found that, of the patients who were referred to their medical centre for back surgery, 58% would be more appropriately treated without an operation. They also found that a large number of patients were being referred for expensive and time-consuming MRI or CT scans, many of which were not necessary. (This is against a background where the healthcare system in the USA wastes up to a trillion dollars a year and preventable medical errors are the third leading cause of death in the country.)

They point out that electronic patient records hold the key to reducing these types of errors. They talk about the fact that, when you shop online, you go through a number of sequences in the transaction which you must complete correctly before you can progress to the next stage. This is all second nature to us now. As a result, our online transactions are “mistake proofed.”

They believe that the same kind of thinking can be applied more widely in the way that electronic patient records are designed and used, helping to deliver safer, better quality care and reducing wasted time and money.

Detailed prompts to improve or standardise care are often buried in medical journals. One of the powerful aspects of electronic patient records is that they can bring these to the forefront and present them to doctors as part of their normal workflow, so that they are applied quickly and accurately at the point of care.

Dr Bender and Dr Mecklenburg want more of these protocols to be embedded within clinical software systems to help guide decision making by professionals, and this should include the wider implementation of “hard stop” tools that would block doctors from actioning inappropriate or unnecessary care plans. They also view electronic patient records as a vital platform for increasing innovation and creativity in the way that healthcare is delivered.

For our part at Microtest, we are delivering more and more GP decision support tools on a monthly basis and are also helping to avoid unplanned admissions to Secondary Care via our innovative products Guru and Planned Care.

Guru appropriately shares a virtual patient record in real-time, to the wider health community, including test results, documents and ECGs, providing relevant clinical information and help in guiding clinicians to a decision on whether or not to admit a patient.

Guru also provides access to Planned Care, a virtual Care Plan system which provides Care Plans, Treatment Escalation Plans and other relevant documents to remote clinicians to help ensure that patients are efficiently and appropriately treated at all times.

There are many more exciting things yet to come and the scope of what these powerful tools will offer for our healthcare system is only limited by our imagination and our determination to help improve patient care.

Read the full, inspiring article