Eric Newman, MD, chief of the rheumatology department at Geisinger Health System in Danville, Pa., was curious about how practical it is to get useful information from an electronic health record (EHR) at the time of a patient visit.
To find out, he and his colleagues examined the EHRs of 50 typical RA patients and assembled a “minimal mental dashboard”—basic information needed for a productive office visit that tells the doctor how the patient has been faring on their current treatments and their present health status.
It was not a speedy undertaking, Dr. Newman found.
“It took an average of 17 minutes—that’s almost the entire clinic visit,” he says. “What it tells us is, in real life, doctors are not looking at the information they need to look at because they simply cannot get it out of the existing EHR. That’s because the information they need is scattered throughout the electronic health record, or not visible in a way that’s helpful to manage patients with complex chronic disease.”
But he thinks he may have an answer.
What is RheumPACER?
He and a team at Geisinger have developed a system called RheumPACER that has been in use for about two and a half years at two Geisinger rheumatology departments. It’s a system that synthesizes information from several sources that are usually scattered, and presents physicians with an easy-to-access guide to a patient with up-to-the-minute information. The web-based system easily connects to the departments’ EHR with a hyperlink.
RheumPACER (PACER stands for Patient Centric Electronic Redesign) synthesizes information from a patient questionnaire that is filled out on a touch screen upon arrival at the doctor’s office. It includes questions about function levels, pain, fatigue, stiffness, social situation, events since the last visit, and other criteria. That information is calculated into disease activity scores, stored, compared to previous values, and sent to the system for immediate viewing by the physician.
RheumPACER also synthesizes information from nurses, the physician, and the EHR.
The information is viewable in a series of tabs, for general information, review of outcome trends, documentation for physician and patient, and quality analysis and reporting.
All of this, Dr. Newman says, saves the doctor and the patient time during office visits and lets treatment decisions be made based on the most current data, so that treatments dovetail with the status of the patient.
“I will have a really good idea about if you’re doing well or not doing well in a quantitative fashion, so that you and I can do problem solving when I walk in the room, instead of interrogating you for the first 10 minutes of a visit to see how you’ve been doing,” he says. “I walk into the room at 30 miles an hour instead of at zero.”