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The Development of an Electronic Medical Record for the Academic Clinician and a Solution for the Competing Electronic Medical Record System
The Development of an Electronic Medical Record for the Academic Clinician and a Solution for the Competing Electronic Medical Record System
Submitted on 08 Feb 2018

Morgan Cribbin1, Eric Reintgen1, Lauren Kerivan1, Michael Reintgen2, Jeff King3, Steve Shivers, PhD3, Charles Cox, MD3, Douglas Reintgen, MD3
1University of South Florida; 2Morsani College of Medicine; 3Department of Surgery, Breast Health Program
This poster was presented at USF Research Day 2018
Poster Views: 264
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Poster Abstract
Introduction: A clinician with a busy clinical practice, administrative duties, teaching responsibilities and an active research effort can find himself overwhelmed with documentation duties in this era of the electronic medical record (EMR). The virtues of the current-day systems are many, with multi-venue access to medical information (as long as the clinic or hospital is part of the system), clearer, accurate and more detailed documentation of services provided for billing and collecting, ease of scheduling and automatic warnings on potential drug interactions. EMR systems have been criticized for making the doctor/patient interaction less personal, being more concerned with financial matters and not being able to get outside system information into the EMR in an organized process that allows easy retrieval. The biggest criticism though has to do with the added time needed to complete the documentation and the fact that if physicians attend at many institutions the EMR systems (Epic, Cerner, Allscripts, etc.) do not talk to each other with no interchange of information. Academic physicians also have concerns about not being able to perform clinical research on their patients populations since they have no control over what data is being collected, how the data is being collected, who controls the data and whether the data is available in the future to conduct meaningful clinical research.

Methods: Faced with these mounting dilemmas in the typical day of a physician, a prospective, customizable EMR was developed by physicians at USF to address each one of these shortcomings.

Results: The melanoma and breast cancer database is an IRB-approved prospective organized database that is used for clinical care in the USF system. In this way it is updated on a daily basis with the validity of data entry being check at multiple levels. Outside laboratory report, pathology and radiologic reports and clinical notes are easily entered into the EMR as they occur and organized by date of occurrence for easy retrieval. The databases interact with the national commercially available EMRs with a cut and paste functionality that supplies all the needed documentation for operative reports and clinic visits. Most important, the physician controls the kind and format of the data being collected and can query on any of the over 100 different variables collected on each patient. As new populations or research studies are incorporated into the practice, screens can be customized, edited or added. In this way clinical research comes to the forefront of the effort and physicians have a much better buy-in with the effort.

Conclusion: Over the past 25 years the breast and melanoma databases of the USF system have been the repository for the data of more than 350 peer-reviewed articles in the medical literature. The database has allowed easy integration into other commercially available EMR that allows complete connectivity for multiple practice sites. Above all, the clinician controls the customizable data input and retrieval that allows clinical research to take place further advancing academic careers. The melanoma and breast cancer database has become a vital part of the everyday life of busy academic physicians.
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