Patient (user)

Individualized EMR, like individualized medicine

Reason why most users of EMRs are unhappy with their EMR is that the EMR seems to have been made with a group of users in mind; the aim is to satisfy multiple needs of as many people as possible. However, a very large proportion of needs of most people remain unmet. Over period of time, the users learn to adapt to the "common minimum EMR" and awkwardly achieve what they need to as clinicians, using them.

A better way would be for the EMRs to be so flexible that every individual user cannot just modify the EMR to his tastes, workflow, needs etc., but also create a EMR just for themselves.

Remote Clinician Support

Glassscribe

Project Concept

Clinician wears Google Glass

What he sees and speaks is heard by a remote assistant

The remote assistant does data entry in real time, coding as necessary. He also prompts the clinician for other data as needed. He reminds clinicians for essential tasks, guidelines. Helps in making decision.

The clinician sees the data being entered in corner of his larger screen and on Glass

If the remote assistant has the right to enter the data into the EMR it is entered directly, else, the clinician can be provided with a copy-paste-able version of the data put directly into his computer clipboard. He just must click in the section of the EMR window where the data will be pasted.

Advantages

Possibilities

• No log in required (when clinician takes off the display automatically shuts down, when puts it on, the retinal scan or other bio-identification method logs him in)

• Instant pulling up of record with scanning of wrist band of the patient

• Data privacy – there is little possibility of anyone taking a sneak peek at your screen or to peruse it in detail if you happen to leave a turned on device or a monitor unattended.

• Remote support (remote clinician) or RT transcription

• AR based measurements (head circumference, fundal height + diameter = uterine volume)

• Data visualization

• Guidelines

• Checklists

• Instant equipment/device manuals with context sensitive help

• Realtime assistance for procedures with AR overlay guidance

Natural language and Semantic search

Examples:

• Find all patients with endocrinal problems (87 patients)

• find the patient who had thyroid problems (12 patients)

• find the patient who had thyroid problem which I saw at clinic x (3 patients)

• find patients who had hyperthyroidism and idiopathic alopecia (1 patient)

Non-intrusive, dynamic clinical decision support

Non-intrusive: does not interrupt any activity that clinician is performing, but depending upon the severity of the alert, becomes progressively 'louder'

Dynamic: as the data is being entered the advice from CDSS keeps updating, without any additional action on the part of the clinician. Since data could be coming from another source, simultaneously (e.g., lab, radiology, pharmacy, family), the advice responds to these too.

Prescriptive clinical decision support when needed

Hide portions of record from patient

Grant care giver status to a family member of patient

Visualization of Data

Ability to see data in a visual format. This helps, for example, by:

• to discern patterns

• to make sense of a large amount of data

• to see relationship between different data types and time

Also, the ability to change the view to see different aspect of the same datasets