mHealthSummit: The Value of an EMR in a Mobile World

The largest event of its kind, the 5th annual mHealth Summit delivers value for stakeholders across the mobile health ecosystem.  The event uniquely gathers healthcare and technology leaders in government, the private sector, industry, academia, providers and not-for-profit organizations from across the mobile health continuum to advance collaboration in the use of wireless technology to improve health outcomes, reduce costs and create a new paradigm in health care delivery both in the United States and abroad.

Intel invited Graphium Health™ to a panel discussion on the value mobility brings to an EMR.

Graphium Health was founded to empower the individuals on the Peri-Operative team, whether the individual is the provider, the administrator, or the patient. This empowerment may be broadly divided into 2 steps: “Data Capture” and “Data Sharing”. Both are of equal importance, both need to be intelligently designed to maximize value, and both need to be tailored to the unique needs of each member of the Peri-Operative team.

Data Capture

An ideal EMR needs to be invisible. It needs to stay out of the provider’s way and allow them to focus on providing excellent care – not on creating a document of that care. It needs to be familiar, so that it doesn’t take a provider’s bandwidth and attention away from the patient. It also needs to be fast. An intelligent conversation and an intelligent understanding of the workflow is critical to designing an effective electronic system that balances both what needs to be recorded and how it needs to be recorded.

Paradoxically, record systems that aim to “collect everything”, actually do a disservice to the patient’s record and arguably decrease safety. They have unintended consequences as users develop shortcuts to regain prior efficiency. For example, they use “cut-and-paste” in their notes, adding little value to the patient’s changing, daily narrative. They over utilize checkboxes to the point that we “check box” only the exceptions, again creating a poor narrative a patient’s clinical state. These record systems end up becoming page after page of unorganized or unfamiliar layouts of mountains of “data” that has wildly varying clinical value.

Not all data is equal. Just because we can record it, doesn’t mean we should. In the practice of anesthesia, for example, there is no need to record the second decimal point of the end-tidal CO2. It’s useless to guiding clinical care. There is no need to record 100 systolic blood pressures per second. It’s of limited value, but comes with a very real price – in both cost and software complexity. Some data needs to be recorded for archival, medico-legal reasons and some data needs to be reported. Those are very different requirements, as one can be achieved with handwriting and the other needs to be discreetly captured in a data warehouse.

So what is recorded and how it’s recorded are both important considerations in designing an effective system.

Data Sharing: Gaining Perspective

Mobility redefines “sharing”. Data sharing is typically described in terms of HL7 messaging between vendors, sharing records with other healthcare providers, or sharing with a revenue cycle management solution. In a mobile world, sharing is vastly broader and reaches more people on more devices at more convenient times. And, when coupled with the capabilities of cloud computing, sharing delivers individualized, real-time, fully customizable analytics. Mobility brings the perspective and timeliness to the individual required to improve healthcare.

For example, in the Peri-Operative space, mobility and cloud computing empower the individual patient, the individual hospital administrator, and the individual provider. For the patient, real-time patient tracking information, care team profiles, and educational information specific to their condition can be used to engage them in their own care. For the hospital, real-time, interactive analytics are distributed via self-guided, web-based software and enable the opportunity for the individual administrator to control their improvement. For the provider, their data is returned back to them, but with the addition of perspective. With their smart phone, they may easily view their personalized performance on productivity, efficiency, and patient safety, as well as how it compares with their peers – in real-time.

Mobile form factors, persistent connectivity, and cloud computing allow point-of-care data collection and real-time data sharing that combine to empower the individual with access to and control over meaningful data, with meaningful perspective. Mobility is an absolute game changer in how we create and consume healthcare data. Its proper implementation is key to transforming healthcare by lowering costs, improving outcomes, and improving satisfaction.