Middleware: The Key To EMR Integration?

By Dr. Donald Voltz

Billions of dollar from private and government funds have been poured into EMRs yet the ROI has not demonstrated a return. Outside of the financial outlay for implementation, training and maintenance of these systems, many other issues are impacting healthcare delivery and safety for patients.

Lack of User Interface Design

There is no question that the primary driver for implementing electronic medical records is to improve the delivery of care to our patients’ in a safe and efficient manner. Yet we have a lack of user interface design, poor or no interoperability, and minimal ability to customize EMR platforms to more effectively meet the needs of our patients. User interfaces that address the needs of various healthcare providers can appear to be unnecessary and window dressing to make physicians happier when interacting with computers, but it is a requirement for better data visualization and to prevent missing critical information.

In addition, design relates to how information is understood and communicated between healthcare providers as well as for patients to better understand their disease and the plan of treatment. All of the major EMR’s are using standard components to present data. None of them have successfully replicated the viewing of complex, interrelated data such as that displayed on a paper ICU record. With this lack of UI design, providers are forced to search through various areas of the EMR to locate it. Even when a specific piece of data cannot be found, medical workers are unsure if the data was collected or was added to some arcane location.

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