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2/7/2014
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Can This Search Tool Make Doctors Love EHR?

QPID, a Partners HealthCare spinoff, creates a clinical decision support tool to solve physicians' big gripe about EHRs -- buried data.

Surgical Robots: Look Who's Coming To The OR
Surgical Robots: Look Who's Coming To The OR
(Click image for larger view.)

The sum of "Google, plus CliffsNotes," might be the formula for making electronic health records software more usable, particularly in large hospital networks that use multiple EHR systems.

That formula is QPID Health CEO Mike Doyle's shorthand for what his company does. It adds search and summarization technology as a layer on top of EHR software to provide more convenient access to patient data when needed most -- the time doctors are making clinical decisions. The EHR world today is like "the Internet 20 years ago when we had all this data but no Google," Doyle said in an interview. "EHRs have done a great job of capturing all this data, but not at making it particularly useful."

A few months ago, in a column called Why Doctors Hate EHR Software, I quoted a pediatrician named Dave Denton on his frustration with EHR software and particularly the "treasure hunt" he found himself going on to find which tab of which screen might contain clinically relevant information about any given patient. Denton sits on his hospital's IT advisory board and believes in the potential of health IT, even as he is dismayed by the reality of it. Although the theory of EHR software is about getting all the information about a patient in one place, finding that information again is harder than it ought to be, he complained.

QPID just might be the map that makes the hunt a lot easier.

[Want more on how some EHRs can be tweaked for easier use? Read Medication Cabinets 'Talk' To Cerner EHR. ] 

The EHR software designer's standard strategy for making information easier to retrieve is to add more structured database fields. But if there is anything doctors hate more than wasting time trying to find information in an EHR, it is wasting time checking boxes on a complex data-entry form.

Like Google search, QPID is designed to find information regardless of whether it is neatly tagged and classified or all stored in the same place by using contextual clues.

QPID, which stands for "queriable patient inference dossier" (but is pronounced "cupid," which you've got to love), was developed at Massachusetts General Hospital by Michael Zalis, an interventional radiologist, and Mitch Harris, the computer scientist who led development of the natural language search technology and medical ontology. When trying to find the clinical context for the images he was sent to read, Zalis found he spent too much time trying to dig relevant information out of the hospital's information systems. He approached Harris, thinking they ought to be able to find a better way.

'Formula' from a QPID marketing slide deck.
"Formula" from a QPID marketing slide deck.

The software spread from Mass General to the other major hospitals in the Boston-based Partners HealthCare system. It has started to be adopted elsewhere. QPID Inc. was launched in 2013 as a Partners spin-off venture backed by Matrix Partners, Partners Innovation Fund, Massachusetts General Physicians Organization (MGPO), and Cardinal Partners. The company is now in the process of building a sales force, with a couple of customer implementations in progress at medical centers in Virginia and Connecticut, which Doyle said he is "not at liberty to name" just yet.

In one particularly advanced application of the technology at Massachusetts General, QPID sorts through both clinical and research data about a specific cardiac procedure and compares the patient's risk factors to best-practice recommendations. The software then gives the physician a simple green light, yellow light, or red light indicator on whether the procedure should be recommended for that patient, a recommendation the doctor has the power to override. If the decision is made to go ahead, the application generates the required consent forms, with the risk factor rating clearly spelled out to help the patient make his or her own best decision.

This workflow is sufficiently airtight, taking advantage of the principles of

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David F. Carr oversees InformationWeek's coverage of government and healthcare IT. He previously led coverage of social business and education technologies and continues to contribute in those areas. He is the editor of Social Collaboration for Dummies (Wiley, Oct. 2013) and ... View Full Bio

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David F. Carr
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David F. Carr,
User Rank: Author
2/10/2014 | 8:51:24 AM
Re: Better search is valuable. Better design could minimize the need for better search.
Have you seen an electronic health records product that achieves the design goals you describe? Or comes close?
dentdavi
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dentdavi,
User Rank: Apprentice
2/8/2014 | 12:40:56 PM
Better search is valuable. Better design could minimize the need for better search.
I am guessing that this works best in HIE connected systems where data from disparate systems is avaiilable, but not in one place. The ability to find the pertinent documents / data without having to open every note or sift through lists of generic labels to identify what you want would be valuable. On the small scale better designed summary pages, labels on notes, and previews of documents without having to open them would go a long way to make individual products more functional.
Laurianne
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Laurianne,
User Rank: Author
2/7/2014 | 12:41:18 PM
What The Doctor Ordered
Interesting story, Dave. This started with a radiologist trying to find a better way-- instead of someone selling to a radiologist. I imagine few doctors can carve out the bandwidth to pursue projects like these.
David F. Carr
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David F. Carr,
User Rank: Author
2/7/2014 | 12:38:47 PM
Anything else like this?
I usually make a point of not being easily impressed, but this approach makes a lot of sense to me.

Have you seen other technologies that layer on top of EHR and provide this kind of search and discovery capability?
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