IT in Healthcare

Implementing EMR: a tough nut to crack

Dr Karanvir Singh, Head Medical Informatics, Sir Gangaram Hospital made an intriguing presentation on how best to implement Electronic Medical Records

Electronic Medical Records or EMR refers to a paperless, computerized system of maintaining patient data, designed to increase the efficiency and reduce documentation errors by streamlining the process. However, contrary to its lucid definition, implementing EMR is a complex, often exhausting endeavor that requires extreme care and a cautious approach.

Dr Karanvir Singh, Head Medical Informatics, Sir Gangaram Hospital is a medical practitioner who has become somewhat of an authority in the area of EMR implementation. At the technology Big3’s Healthcare track Singh made an intriguing presentation on how best to implement EMR and gave some invaluable insights to the medical professionals attending the event.

He began his presentation by defining EMR and said that implementing an EMR is difficult primarily because of two reasons viz. doctors and the way in which data is entered in the system.

“If a doctor has to see 10 patients in one hour, we can’t expect this individual to spend three minutes per patient making entries in the EMR,” said Dr Singh. “These implementations become even more difficult in busy hospitals where there’s a constant flow of patients. In addition to this, sometimes the EMR systems themselves are designed in a way that does not allow for the fast and error-free entry of patient information.”

Referring to the implementation carried out by him at Sir Gangaram Hospital, Dr Singh said that a good EMR design should be user friendly but not at the expense of functionality and while there are no guarantees that an expensive EMR may be the most user friendly one, local customizations have to be done in order to achieve success.

Talking about how he did it, Dr Singh talked about a carrot and stick approach which was applied at Sir Gangaram Hospital where the data in the EMR is summarized into a discharge summary that is given to the patient. Dr Singh is of the opinion that something as trivial as an automated discharge summary can act as a strong incentive for doctors to start using the EMR

He cautioned that hospitals should not start EMR implementation till some ‘carrots’ (such as automated discharge summary or data analysis module) are ready because otherwise ‘sticks’ won’t work for long.

Stressing on the criticality of strong leadership Dr Singh said that the person in-charge of the EMR initiative should be a mix of doctor, IT professional and a visionary because otherwise even a minor bump can send things into a downward spiral.

Towards the end of his elaborate presentation Dr Singh advised hospitals to adopt a gradual, phased approach to implementing EMR and said that introducing all the functionalities at once may make it too complex for doctors and lead to major change management issues.

Singh ended his presentation by referring to the benefits witnessed at Sir Gangaram Hospital and said that a comprehensive EMR system can greatly improve quality of care by keeping patient records up-to-date and easily accessible, allow hospital staff to track patients needing follow-up care, hospital’s ability to help patients manage treatment of complex diseases and even allow clinicians and researchers to analyze data and long-term trends.