EMRs suck.
Physicians spend a third of a patient encounter using their EMR. At the same time, the average length of a patient encounter has reduced down to as little as 10 minutes.
Is this what the future of medicine is supposed to be?
Defining our terms: EMRs are Electronic Medical Record systems, while EHRs are Electronic Health Record systems. There does not exist a clear delineation between the two, instead, they could both be called Patient Information Systems today. When we say EMR, we are referring to EHRs also.
We use the term EMR, because it is much more familiar to our international audience than PIS would be, and because it is a term which can be used to accurately track the advancement of medical records.
We believe that modern EMRs suck due to misaligned incentives and lack of input from those whose work these systems most directly affect.
We must begin our story well back in the 1950's, when investment into health and welfare became central after a violent start to the 20th century. Technological breakthroughs in the military and national security domain were put toward civilian benefit. ARPANET became the Internet, and NASA's efforts in space gave us the MRI, to name two prominent examples - though there are thousands.
During this period we saw the formalization of the medical workflow and the documentation thereof, and systematic archiving. The "medical record" started out as a piece of paper with a title and certain expected content. The "anamnesis" or "the structured reconstruction of a patient's medical history through an interview" is just one of these.
So, from the 1950's to the 1960's we saw massive increase in the amount of medical information that was recorded, it was inevitable that someone would look at this newfangled "computer" thing and think "could this solve our problems?"
The answer we believe is yes. But only if the digitization (the effort of turning analog, paper records into an electronic format) represents the totality of records. Instead, modern EMRs trace their roots to a digitization effort driven by, and steered by, the needs of administration, not physicians.
Beyond the medical records there were never digitized (certain nursing medical records, for example), what the digital medical record took from us is flexibility. A paper invites the writer to write whatever they feel is relevant or pertinent. A structured document that screams errors at you if you select the wrong option does the opposite.
In principle the EMR defined the end of the paper era - unless you want to share specific information between hospitals with different EMRs and no digital connection, then out comes the fax machine or printer.
At Onesys, we believe that the problems of EMRs cannot be solved by improving them; that their very architecture makes this effort implausible.
Instead, we approach the EMR as a foundation to power rich digital software.
While most medical IT companies are aiming toward things like harmonization of formats (FHIR, SNOMED CT, OpenEHR), we work directly with the underlying EMR system and have no such need.
What we offer the busy clinician is a space, a clean slate, into which they can record their thinking, document the decision making, and support said decision making with medical evidence, such as mathematical functions derived from test results, or specific medical images that they feel best support the decision.
What we offer the busy clinician is a "web browser" to the complex "internet" that is EMRs.
The Onesys Navigator.