In some ways, hospital and clinic EMRs have the same job to get done — to assess, test and treat patients. But they do have to be optimized differently, as hospitals and clinics do things at a different pace and of necessity are organized differently.
Here’s some of those differences, courtesy of TELUS Health’s Shawn Vincent:
* Difference number one: Minutes count
Hospitals care for patients in acute situations, where minutes or even seconds can determine the patient’s outcome. In medical practices, “care is measured in weeks, not hours,” Vincent notes.
Result: Hospitals need test results immediately, where clinic patients can wait until their next visit days or weeks later.
* Difference number two: Patient departures
In hospitals, patients consume resources until discharge, and that doesn’t happen when tests and treatments are still outstanding. In clinics, patients can leave while tests are outstanding or treatment results are still pending.
Result: Hospitals must perform well at “round trip” test and treatment management.
* Difference number three: Who runs the show?
Hospitals are generally run by a large corps of professional leaders, including boards of directors, business expects, lawyers and many other stakeholders. Medical practices, traditionally, owned by doctors who practice there, and are responsible for care, documentation, and ultimately, liability for all that takes place.
Result: Hospitals usually have tough rules in place about how medicine can be practiced, and also how it is documented, which roll down to everything from how the EMR user interface looks to how events are audited. In clinics, doctors make their own rules.
* Difference number four: Short vs. long-Term Care
Hospital encounters usually call for just enough information to treat the patient — more can be a distraction which slows down care. In medical practices, on the other hand, having longitudinal data on the patient is central to caring for them over the years.
Result: Hospital IT systems must be artfully designed to display “just enough information to make a meaningful medical decision without distracting the user with unnecessary details,” he notes.
Readers, what other differences between hospital and medical practice EMRs do you consider to be important?
My reaction was that if you are patient centered the only difference in outpatient vs hospital, a continuum of care, would be the billing codes. I disagree that test results in a clinic could wait a week or that doctor’s need a less focused summary or that hospitals don’t need a detailed history. Short vs long depends on the medical issue and the Doctor should be the decision maker in charting.
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