Clinical information systems vary depending on their location of use:
- Hospital inpatient systems (such as Cerner, EPIC systems, GE Centricity) are highly structured and are designed for sharing of clinical notes and diagnostic tests between different departments and wards. These systems are optimized for computerized provider order entry, sharing of procedural and operative reports, and collating all information related to a patient’s management in the form of a discharge summary. Inpatient systems are optimized for episodic care.
- Community-based systems function quite differently. They are focused on capturing information that is configured to reflect the needs of individual physicians or groups of physicians who are directly caring for a patient. These are provider centric tools that capture detailed information about a specific patient over a length of time.
- There is another category of EMRs that are used in hospital ambulatory clinic settings, i.e. outpatient clinics. These may be a module or component of the hospital inpatient system, optimized for outpatient management, or could be a completely different product. Outpatient systems are designed for clinical documentation, ordering investigations through hospital diagnostic facilities, booking procedures or surgery in the hospital, or prescribing medications to external pharmacies. These systems are a hybrid of the community-based ambulatory EMR and hospital inpatient systems.
Working in multiple locations using paper charts has inefficiencies; however, there is no need to learn different navigation or documentation processes. A paper chart is a paper chart. The same cannot be said for clinical information systems.
Remembering a unique login and password for each system adds complexity for users. Add in upgrades and training on new features and it becomes quickly evident that keeping current with upgrades and modified processes is a major task.
How many clinical information systems do you have to use in your clinical practice? Share your experiences.