Medical doctors receive compensation largely from insurance companies and government programs. These entities make predetermined payouts for the procedures administered by the doctors, regardless of how long the procedure actually took. The result is doctors have less and less time to spend with their patients, and thus less time to study a patient’s medical history prior to servicing their patient.

Traditionally, doctors flip through paper records with the objective obtaining enough of an understanding of the patient in just a few minutes. In an attempt to address this, some progressive doctors (around 10%) have implemented Electronic Medical Records (EMR) to help them maximize their time with their patients.

Our client was an EMR consultant, who specialized in implementing an EMR system called NextGen KBM.

Challenge

The problem is that patients can accumulate a lot of medical history, which consists of a myriad of different types of medical data, such as doctor appointments and notes, x-rays, tests, referral letters, medications, etc., which do not translate well to the computer screen.

The approach taken by EMS is to present one long page of all the information in chronological order. The doctor would scan charts by dragging the scroll bar. As charts can consist of 20 or more pages, this approach is very slow, tedious and offers little improvement over paper charts. This is one of the reasons why doctors have been slow to adopt EMR.

We were engaged by the client to develop a better solution for them to offer to their doctors.

The Solution

Through data analysis we identified that despite the copious amount of data, there were actually just 3 types that we classified as: Event, Result and Duration. Event data were single occurrences such as a doctor visit, an injection, MRI, referral letter, prescriptions, etc. Result represented continuous data such as regular tests that could be plotted on a graph, while Duration data would be items that span time, such medications taken over a period of time. We also recognized that all the data was date stamped.

The solution was a single screen layout, using the horizontal access and columns for timelines and the vertical axis for the 3 data types.

Timelines were dynamic, so the doctor could select the information they wanted to see based on the time period of interest, e.g., last 2 weeks, by month, by quarter months, 6 months, a year, 5 years, 10 years, etc. They are also able to move backwards and forwards through the timeline by clicking on the left and right arrows. If the doctor wanted to drill down and view the x-ray, see the details of test results, read a referral letter, they simply click on that item on the screen.

Customer Benefits

The system made it easy for the doctor to get the best possible preparation of a patient’s medical history in the shortest amount of time. In addition, the doctor can quickly isolate the timeline and medical information of interest and rapidly review the details, without having to wade through non-pertinent information.

Other benefits not previously possible enabled the doctor see how events and medications might be affecting tests. For example, if there was a spike in some test results, the doctor can make a diagnosis in just a few seconds by simply glancing up and down the screen.

By viewing the graphs in the Result data and altering the timelines, the system makes it possible to identify trends. The system was very simple, very easy to use, requiring little or no training. It was also designed to integrate with any EMR product, dramatically improving the value of any system and greatly increasing the ROI on that system.

Core Technologies

The system is based on PHP and SQL, and will function in a Microsoft or Linux environment.