Functional EMR Design: Diagnosis Search and Select

Solving the Problem Problem

This is a follow-up to the article the “Coding For” fallacy, which was titled after the perennial chorus of complaints from medical billing departments: “clinicians are always coding for the wrong diagnoses!”.  That article addressed some of the complexities of ICD coding, and the EMR design issues that deter clinicians from choosing the best diagnosis codes when they bill for their work.  In this installment I show an EMR design solution that begins to address the root of the problem.

Introducing “oriole”, my own (imaginary) EMR.  The video link below shows how Diagnosis Search and Selection should work in a functional EMR system for primary care.  If you are an EMR user, you will know exactly why I did this, and how different it is from most EMR experiences.  If not a user, you may wonder, “what’s the big deal?  That’s how software is supposed to work!”

What I show here is an introductory design, and certainly not intended to cover every special case. Diagnosis search can be much easier using customized compendia for specialties, customized person lists, and other such configurations. And oriole would certainly work alongside such solutions. But I’m starting with open-ended, primary care examples because I maintain that if a solution works there, it will work anywhere.

To EMR developers: take this as a challenge.  I’ve been demonstrating design ideas and improvements to several vendors over the years - which are always appreciated, but seldom implemented.  Which vendor, when, how, will engage with me to make the oriole approach a reality?

To my clinician colleagues: what do you think?  What use cases would you present to challenge this approach?  What oriole features would you like to see next?

Stay tuned for more content currently in the works - the next video covers Diagnosis Assessment and Coding.

The Functional EMR Guy: This channel offers a view of ambulatory EMR technology from my experience as a clinician, clinical informaticist and software engineer.  My driving vision is a practical approach to functional analysis and design, to help clinicians help patients by creating better EMR systems. Please subscribe! I won’t send spam or share your info.