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Facebook EMR

September 11, 2008

The simple idea in this article from Dr. Bob Wachter should change the entire course of electronic medical records development.

Let me take his idea one step further.  Use a Facebook-like interface to intergrate the physician’s EMR with personal services such as Google Health.  I envision it this way: essentially patients and doctors have FacebookEMR identities and can link up with each other (in order to prevent FacebookEMR from devolving into a regular social network, patient’s would be prevented from linking up with other patients).

Let’s look at it from a patient’s perspective:
*Facebook terms are in parentheses and italicized to easily draw the parallels

I logon and am able to see my complete EMR.  I can view anything my doctors can view.  However, I can’t change or hide any of the information contained in this record (whereas, my doctors will be able to).  I can grant different doctors viewing privileges in the system (in Facebook-speak, I could add or subtract docs as “friends” as they move in and out of my care team).  In addition, I see an ongoing, continuously updated listing of added test results, medication updates, referrals, basically all news related to my care, updated in real-time (a News Feed).  More importantly, I can electronically and securely communicate with my care team (instant messaging or wall-posts).  I am able to add applications developed by independent software designers to remind me of different care procedures for my chronic conditions or provide me with ongoing counseling for health problems.  A patient’s “friend” list would simply consist of members of their current care team–primary care physician, hospitalist, physical therapist, social worker, nurses, specialists, etc.  Thus, each person on this list could see (via the News Feed) the most current procedures for the patient and have easy access to any necessary test results.  Perhaps the biggest benefit of a system like this–open communication.  A person communicating with the patient via wall-posts would have his or her comments displayed so that all of the care team members could read it and see what was said or done.

From a doctor’s perspective:

They could logon and do all of the things current EMRs do, plus the communication tools I’ve mentioned.  However, the provider’s login page could also show thumbnails of each patient current under their care.  The physician could click on any of the patient’s and be taken immediately to their “profile.”  In this opening view, they could quickly view the patient’s “News Feed” (to see what is currently going on with the patient, what tests have come back, who has ordered another test or procedure, nursing notes, etc) and the patient’s “Wall” (where communications between the patient and other providers would be displayed, as well as various healthcare professionals leaving short notes for other’s to read–“Head’s up, Mrs. X’s fever is spiking so I’ve started prescription Z, keep an eye out Y.”)  This would allow providers to keep up with their patients continuously, without waiting for a consultation note to be dictated and sent to their office.

I think Facebook users will be able to more easily understand the picture I am trying to paint.  Unfortunately, I’m not confident I am doing a good job of describing what I see in my head.  I wish I had graphic design skills so I could whip up some screen shots of what I envision.

Despite the huge potential I see for a system like this, I’m not going to hold my breath.  Unfortunately, health IT seems to be 10 to 15 years behind the rest of the technology world.  Actually, EMRs are a great example.  The world is moving on to Web 2.0 and health IT is still struggling to get its first version out.

Maybe I could help things along if I magically acquired advanced programming skills, stopped sleeping, and started programming 24/7…

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