Add-on Apps Can Supercharge Your Orthopedic EHR

Ira H. Kirschenbaum, MD


April 02, 2014

In This Article

EHRs Are Useful, but They're Not Enough

At a recent meeting of the American Academy of Orthopaedic Surgeons (AAOS), I was asked to give 2 lectures on information technology (IT) in medicine. I have been lecturing on this topic for over 20 years, but this year there was a definable change in the interest level of the participants.

In years past, most participants were interested in understanding how computers work and how many of the information processes and programs do digitally what the participating physicians did on paper. The pressing interest of so many of my colleagues who came up to me after the talks was about getting a functional and happy life back.

It seems that the electronic health record (EHR) programs they purchased and the EHR programs that were used in their institutions were destroying their productivity, increasing their documentation time, and upsetting their patient-doctor relationships at all levels.

I get that. I see it every day. It doesn't happen to me, but I can see how it happens. Before I continue, a caveat: I am a very high-end computer user. Despite this expertise, I don't think my computer training and skill are the reasons for my enjoyment of my digital world. I believe it is because I am "unfaithful" to the EHR I own. Let me explain.

"There is the IT you marry, and then there is the IT you fool around with." This was one of my main slides in my talk, "Killer Apps," at the AAOS meeting this year. You really are married to EHR programs, especially if you are hospital-based or in a large group. While these programs may appear burdensome, they do meet key necessities.

For example, there is the security of the system, both of protected health information and integrity of data. Important compliance functions are in place. Prescription writing is nearly error-proof, and that alone is a powerful feature.

When you add all of the features of a certified meaningful-use EHR, you can see what a stable practice home life a standard EHR can give. The problem is that most of us really do need more, and my recommendation is that, while you are married to your EHR -- and even more happily married than you may suspect -- it is time for you to cheat on this mate and start having affairs with third-party apps and programs that will give you the functionalities that you are missing.

But first, it's important to understand what those missing functionalities are.

Crucial Data Go Uncaptured

Some important daily activities that we perform as physicians have simply been ignored by nearly all EHR vendors. As surgeons, we have some fairly basic goals. We want patients to have access to appointments in our office. We want to be able to accurately and efficiently document an encounter. We want to schedule surgery, make sure our scheduled patients actually get to the operating room (OR), and safely track these patients when they get admitted to the inpatient floor or are discharged to the outpatient setting.

On the business side of our lives, we want to track the source of these referrals. We want our documentation to be as complete as possible. We want to capture all encounters, such as emergency department (ED) visits and floor consults. And we want to process the surgery claims.

When I saw early on that my EHR offered little help for these important functions that affected my life, I decided to either find existing programs that did or use off-the-shelf solutions to develop the software that would give me what I wanted.


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