Emergency Physician’s have relied on electronic medical records, in some form, for decades now. From stat laboratory data and patient locator software to integrated Zoll monitors that streamline the recording of codes, the accuracy and reliability of these data systems are paramount for delivering high quality emergency care. The sophisticated technology is undermined, however, when power failures hit and communication channels are compromised. Fortunately, contingency programs can be integrated into Electronic Medical Records Systems (EMRs).

EMERGENCY MEDICINE-SPECIFIC EMRS

The EMR System you choose needs to interface with the various systems in place throughout the hospital. From the time a patient sees the Triage Nurse and is put into a room, an ideal system would have a single interface that integrates these data with the patient’s medical history, imaging, and patient records from regional hospitals. The dozens of small steps in the process of patient care in your unique Emergency Department should be able to seamlessly integrate into a user-friendly experience. For example, if you do physical exams, x-rays and ultrasounds all in different rooms, you need your EMR to be able to automatically migrate all of the patient’s data so that it is accessible from any computer. Therefore, we will begin here with the assumption that all patient records will be easily accessible from one user interface, not multiple software programs for different types of records.

VERIFY EQUIPMENT AND SOFTWARE COMPATIBILITY

Many trauma transfers and referral patients bring CD-ROM’s and documentation from hospitals and physicians that use different machines and software than your hospital. Choosing an EMR based on the myriad of consultant’s and referral hospitals’ equipment is difficult at best. For example, if you use the Siemens AR Star CT Scanner, but an outside hospital transfers a trauma patient with CT images on a CD-ROM from a Toshiba Asteion ER004, you need to make sure that your department’s software will be able to read the disk. The days of needing a double-dose of IV contrast to repeat a CT scan because of incompatibility are nearing an end.

BUILDING TRUST IN YOUR EMR SYSTEM

In addition to software and equipment compatibility, the right EMR for your Emergency Department should make your workflow easier, not harder. Your daily operations and patient flow through the department should not have to adapt to accommodate an antiquated EMR. It should be the other way around.

In the event of a disaster, make sure you have contingency plans for power and communications failures. Investigate the EMR you’re considering thoroughly to determine if it has the ability perform data recovery and system backup. Be sure you have a system in place that you can trust to alert you to critical developments.

EASILY TRACK STAFF AND PATIENTS’ ACTIVITIES

Verify that your EMR will seamlessly integrate triage notes, ER visit history, previous elopements, as well as all past medical history. Automatic visual and/or auditory notification of critical laboratory tests and contraindications for medication administration will improve outcomes. From documenting triage decisions and patient contact times, to tracking which personnel log into the EMR, many repetitive tasks can be integrated into an EMR system that curbs human error and improves department efficiency.

DICOM COMPATIBILITY

Digital Imaging and Communications in Medicine (DICOM) is a standard construct used increasingly by Health Information Systems, but it is not universal. Specifically, DICOM covers handling, storing, printing, and transmitting information in medical imaging.

Typically, different imaging systems and software are used to render different modalities, such as ultrasound, CT, and MRI. The danger of putting all imaging modalities in one viewing system is that it could fail. Therefore, redundancy and parallel backup systems are needed. Because you will view color video of Doppler ultrasounds along side plain x-rays and graphical data, the EMR System you choose will likely need to meet the DICOM standard with PACS compatibility.

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