Value Add

Wellness Aided by Technology

Implementation of ezEMRx serves the needs of Manipal Cure and Care. Priti Pathak tells you how

"The idea behind choosing an IT solution was to set consistent standard across all our wellness units" - Hanuman Jayaram Head IT Manipal Cure and Care.

Manipal Cure and Care (MCC) introduced the concept of wellness along through its retail healthcare model, with six units at different locations like Mumbai, Pune, Ahmedabad and Bangalore with wellness, preventive, beauty and cosmetic care as the focus area. MCC wanted to have an IT solution which will be utilised for personal interactions while bringing in operational efficiency along with enhanced customer experience.

They were looking for a solution for easy data sharing among all the units of MCC. "The idea behind choosing an IT solution was to set consistent standards across all our wellness units," informs Hanuman Jayaram, Head IT, MCC. MCC's search for technology to meet the above needs were fulfilled after they were approached by ezEMRx Inc. ezEMRx Inc, the provider of 'ezEMRxClinical software,' is a US based company focused on providing technology innovations in healthcare. MCC is their first client in India. Since MCC was looking for a web interface application through which all the units can stay connected and share common data, ezEMRx meets this need for them. Customisation and localisation services on ezEMRxClinical, integration and implementation support, training and innovations are some of the other services offered through their subsidiary 'Syntax Soft-Tech.'

Appointment Scheduling

This encompasses of the registration process at MCC. When the patient approaches the registration desk, the receptionist is prompted to fill in the required details about the patient with the digitalised picture of the patient. All this gets recorded and then the receptionist issues a unique identity number to the patient. After this, the doctor's 'to-do-list' gets updated with the patient information. So that he knows before hand as to which patient would visit next for consulting. Due to this system, blocks of time can be reserved for certain types of appointments or treatment procedures on specific days and also the length of appointment parameter can be adjusted depending on the time a physician would devote to each encounter with the patient. "This makes it convenient for our physician to follow a schedule and allowing time management since time can be used effectively," explains Jayaram.

Task-based Approach

When a patient enters the clinic for consulting, the physician opens a work station on his/ her computer system. This work station is in a wizard format with a structured set of questions related to the disease. The text templates are formulated using a tree concept which utilises drop-down lists, check boxes to speed up data entry procedures while patient encounters. Each template features standard problems, allergies, medications and symptoms list. Depending upon the physician's specialty at MCC, the contents in the template would vary to allow a task based approach. He would ask queries related to the patient's problem and make entry in the ezEMRx in the form of keywords. Later, this gets recorded and the report is generated in complete elaborated sentences giving a brief idea about the patient's problem. At the end of many interactions patients are given instructions for ongoing treatment of a disease or recommended for further diagnosis.

Schematics and Image Management

This feature in the ezEMRx allows the captured printed documents and clinical images and imports them in the patient's electronic chart. Here, the hard copy is converted into electronic data and stored in the database along with the patient's record along with his previous encounter records. This system ensures that all imported images that come at MCC are automatically catalogued by patient, data and image type.

Lab-Order Entry

ezEMRx's lab module enables the option to order and receive lab reports in a matter of few clicks. When a patient undergoes any test the lab physician makes a record of the sample when the report is generated. This is stored in the system from where the doctor can access the reports on his computer.

Device Connectivity

ezEMRx supports connectivity with diagnostic devices like ECG, ultrasound and so on. This creates interfaces to transfer data captured from the above mentioned medical devices via cable directly into the patient's record. This facility eliminates the need for staff to manually enter information into the patient's Electronic Medical Record (EMR). This also eliminates the chances of transcription errors and other related problems. This connectivity has provided the physicians at MCC, real-time access to updated patient records which ultimately ensures quality healthcare.

Current Index of Medical Speciality (CIMS) Database

CIMS is a medication database, designed specifically to enhance physician's interactions. This feature works like an alert while prescribing drugs. When a doctor prescribes a drug to the patient, he would receive an alert on his system whether the patient is allergic to the drug or not. Other instance would be when a drug is prescribed of a different brand, then again the physician is alerted that if there are chances of drug interactions. Thus, it has prevented the encounters of medication errors. "This application is introduced at MCC, right from the beginning stage so I feel that we have taken a precaution before the occurrence of any related problem," says Dr Satish Amarnath, Director, Medical Services, Manipal Cure and Care.

Voice Recognition

ezEMRx allows the physicians to enter data using third party voice recognition software. With this technology all that a physician would do is speak through a microphone connected to the workstation/ computer. The letters, notes are entered verbally with words and then it gets converted into text, thus saving time. Yet another aspect is that doctors are generally known to have bad handwriting, so there is a possibility that while prescribing medicines in written format the pharmacist ends up giving a wrong drug. But when the same information is told verbally the software has the capability to record it in text, thus avoiding prescription errors.

Advanced Security

At MCC, security of patient is very essential. The prospect of storing health information in electronic form raises concerns about patient privacy and data security. Any attempt to introduce computerised healthcare information systems should, therefore, guarantee adequate protection of the confidentiality and integrity of patient information. At the same time, the patient information also needs to be readily available to all authorised healthcare providers, in order to ensure the proper treatment of the patient. ezEMRx incorporates a number of security mechanisms to prevent unauthorised access of records and to maintain legal integrity. Security is controlled for each group of users like the front office staff, doctors and lab physicians. Each user session requires an authorised login and password.

Challenges

So keeping consistency in the services across all the units was a major challenge. Another fear lurking was that automation might make staff redundant. But, on the contrary it has created more opportunities and also increased the productivity of staff like nurses, since it has freed them to perform nursing activities rather than boring clerical work of managing indents and stocks. "Implementing the integrated solution across multiple centres and supporting the same was a major challenge. This was overcome by drawing out implementation plans and checklists well in advance," exclaims Dr Amarnath.

priti.pathak@expressindia.com