Alternative Electronic Medical Record (EMR)

Alternative Electronic Medical Record (EMR)

I spend a lot of time in the EMR. EMR's certainly have their issues but overall for my practice it has been a net gain. As best I can tell, the only pseudo-medical module in my EMR is one for acupuncture.

One of the handy features of the EMR is the ability to see labs and notes of my patients in other hospital systems that use the same EMR. In Portland they all use EPIC and includes the local ND school/clinic where I have seen a few chart notes on my patients.

However, the EMR is not geared towards alternative medicine, and in the US where there is a need, someone will will the need. Power2Practice

is an essential software solution designed for Integrative and Functional Medicine.

They offer some interesting features that would benefit an integrative medical practitioner.

They can create custom compounds, access more than 30 IV therapy protocols, order labs from 'specialty' labs,  use integrative medicine specific forms and questionnaires, and be able to choose from 30,000 nutraceuticals with a patient-direct supplement ordering and distribution program in the works:

Soon, you'll be able to grow your vitamin and supplement revenue, increase reorders, decrease inventory costs, and improve patient adherence by using our online vitamin & supplement function. Your patient will receive an email and link to their secure patient portal, noting that an action is needed. In the portal, the patient will be directed to their private shopping cart, pre-populated with the recommended products. They input payment information, and the product is drop-shipped to their location. The order is automatically recorded in their P2P records.

Completely bypassing the AMA ethical guidelines,

(1) Physicians who choose to sell health-related products from their offices should not sell any health-related products whose claims of benefit lack scientific validity. When judging the efficacy of a product, physicians should rely on peer-reviewed literature and other unbiased scientific sources that review evidence in a sound, systematic, and reliable fashion.

I suppose the prescribing doctor will know which of the 30,000 nutraceuticals meet that standard.

(2) Because of the risk of patient exploitation and the potential to demean the profession of medicine, physicians who choose to sell health-related products from their offices must take steps to minimize their financial conflicts of interest.

No worries since with the EMR they are not, of course, technically selling the products in their office, but on a portal.

All that plus the usual charting and scheduling modules.

They do offer one feature I can't really understand the utility of:

Custom Lab Ranges 

Create custom reference ranges for lab work.

Usually the reference range of, say, the white cell count is determined by the lab doing the test. The lab measures 100 or a 1000 normal people with a given methodology. This usually results in a tight bell curve of values and the normal range is then determined by several methods.

Different labs may have slightly different reference ranges and, depending on the test, there may be gender or racial differences. My estrogen level is hopefully not the same as my wives.

I don't get to decide what is a normal reference range, that is determined by the lab and the test being done. I don't get to say the lower limit of the white cell count is now 9.

Altering the lab reference range in my opinion would be like inflating the numbers at your inauguration; it turns the reference range into an alternative fact.

As best I can tell from the website, the reason for custom reference ranges is to assign goals for whatever I would consider to be an optimal lab value, but that is not what a reference range is. I can't tell from the website if, when the patient logs on the portal to see their labs, such an important distinction is made. I am probably missing something.

Laboratory values are very powerful for many patients. Being able to alter the reference range offers great potential for abuse by the unethical. Good thing that isn't going to occur with integrative medical practitioners.

Points of Interest 04/07/2017
Points of Interest 04/06/2017