Add-on Apps Can Supercharge Your Orthopedic EHR

Ira H. Kirschenbaum, MD


April 02, 2014

In This Article

Add-on Apps as a Solution

An app is a software program that allows you to do one or more tasks. There are desktop apps and mobile apps. In IT street culture, an app is usually reserved for programs that do a small number of specific tasks.

A classic example of an app is OpenTable®. OpenTable is a desktop and mobile program that allows you to find restaurants in your current location that have open reservations. You can make the reservation through the app. However, the app does not manage your entire eating experience. It does not choose the person you are eating with, get you transportation to the restaurant, give you guidance on which wine to choose, or offer suggestions on where to go after the dinner, but you can find apps for those things as well.

It really does not matter whether you find a commercial app that offers the functionality you need or develop your own app using some off-the-shelf app-design program. Either way, we need these apps to reach our goals. You can purchase a wine selection app that gives you advice on what to buy. You can also buy a book on wine and enter the recommended wines into a note-file app on your smartphone, and you may have something almost as good.

EHRs have solved a number of problems in surgical practices, but they have also created gaps in the process. I have found a number of key functionalities that are glaringly absent.

Dr. B, for example, needs the following: (1) a way to fit more patients into his office hours to get more joint replacement procedures; (2) a way to track the surgical process from indication, to the OR, to discharge, to successful outcome; (3) a way to track the medical encounters of his patients when he is mobile; (4) a way to track the activities of home care and other outpatient services that affect his results; and (5) a way to analyze the revenue and costs generated by the system.

Dr. B needs these functionalities now, and the EHR is years away from offering them.

As the chairman of an orthopedic department at a large urban hospital, I had to find solutions to these issues. The scope of this article is not to give reviews on which apps I used and/or developed but rather to give you a framework for how to consider, find, and deploy app solutions that can be overlaid onto your EHR and daily medical life.

The first step is to understand your problems. Dr. B, of course, is clueless. Having read this far, you probably have a sense of how to look at the potential problems in the process management of your practice situation. Next you need to analyze the human and technological resources available to you. You then need to spend time with your practice managers to develop a plan that will connect solutions with problems.

We did this at our hospital and found that we needed to develop our own apps because our EHR failed to solve key problems. We developed these apps with off-the-shelf app development software, and after time-testing them in over 25,000 patient interactions in the ED and the OR, we decided to package them simply and make them available to colleagues.


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