Best Practices: The Electronic Medical Record Is an Invaluable Clinical Tool: Let’s Start Using It

Many clinicians have had the experience of being handed a heavy patient file with thousands of historical notes to review for an intake. But some electronic medical records (EMRs) are just as unwieldy, chock-full of useless information that obscures clinically relevant material. This month’s Best Practices column describes an attempt to reengineer the EMR as a graphical, single-page dashboard that displays patient history, measures progress, and facilitates clinical research.

This column describes the potential of an enhanced electronic medical record (EMR) to advance best practices by displaying patient history, measuring progress, and facilitating clinical research. To create a graphical, single-page display of patient history, the authors examined data in the Minneapolis Department of Veterans Affairs EMR system, including 1.8 million encounters for 50,000 mental health patients. The prototype dashboard presents information on a patient’s current and past providers, diagnoses, therapeutic interventions, prescriptions, dosages, and outcomes. To provide needed outcome data to monitor patient progress, the authors tested two questions with 212 patients. Patient and clinician responses to the questions provide reliable and clinically useful data that can be used in the EMR to track patient change over time. Use of EMRs can bridge gaps between science and practice to inform diagnosis and treatment decisions and permit more accurate prognoses.