Sunday, April 02, 2006

How good will my data be?

I spent the past two days at a conference organized by my University's department of Family Medicine. There was certainly a lot of interest in EMRs; it will now be possible to contribute data for large studies. If (God forbid) we ever do get an influenza pandemic, it will be incredibly useful to be able to track things like patient temperatures directly from the charts in family medicine. I remember how helpless and out of touch I felt during the SARS crisis, and I hope better communication will help if there is a next time; SARS killed a family doctor.

The researchers will have to be very careful with protecting patient and physician confidentiality. I have done a bit of research in family medicine, and probably should think about how to use the EMR for that.

The EMRs are customizable, which is good because this lets you put in the data in a way that fits you best. On the other hand, everyone will enter data in somewhat different ways, so the charts will all look different. As well, there is some "free text", which is where you can enter things in any way you like. The free text is the easiest way to enter information, but will probably make it more difficult to search for things in the future. There will need to be some balance between "hard-set" entries, where you have to put in data in a certain way (so that you can do audits for things that interest you and to improve your practice), and ease of entry. A tricky proposition.

Maybe we should think at some point about making records more similar across many practices, so that we can share data more easily (for example, transferring a chart to another family physician, sending data to a specialist, to Diabetes education or to a hospital). I know that Canada Health Infoway is working on common standards (HL-7). It would be good if there was a common standard: if an EMR company goes under, the patient data is too valuable to allow it to be lost. A common standard may help to transfer the information into a different platform.

Perhaps, in the meantime, groups of physicians using the same software application can decide to record things in similar ways. I don't know how easy this would be (probably very hard), or how exactly it would be done. Maybe physicians who are interested could get some help with that.


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