Special considerations for Ophthalmologists
Eye specialists or ophthalmologists have special considerations in choosing an electronic medical record.
Some of the elements duplicate the meaningful use requirements, but others are unique like supporting the AAO Preferred Practice Patterns:
- organizing eye-specific elements separately including past ocular history and ocular medications
- supporting ocular drawings with ocular templates
- exchange ophthalmic clinical data with EHRs from other vendors
- record VAs and refractive discrete elements in accordance with DICOM supplement 130
- record intraocular pressure as a discrete data element
- support vendor-neutral standards and profiles for orders and data from ophthalmic instruments.
EHR vendors protested the requirements for vendor-neutral instrument standards as ophthalmic instrument vendors have been extraordinarily slow to adopt DICOM and other standards in new equipment with the minority of new meeting a vendor-neutral standard. Due to the 10 to 20 year replacement cycle for ophthalmic equipment, the majority of equipment in use is non-compliant.
Other requirements are process-oriented and aimed to improve practice efficiency. One unique requirement is "enable physicians and technicians to keep multiple records open simultaneously and securely in different rooms, with easy re-authentication" which may have possible usability and patient error implications if the wrong patient's record was edited. Others are more standard like integrate clinical documentation charge capture with practice management and allow physician to easily review patient information before entering room.
- Special Requirements for Electronic Health Record Systems in Ophthalmology. Michael F. Chiang, Michael V. Boland, Allen Brewer, K. David Epley, Mark B. Horton, Michele C. Lim, Colin A. McCannel, Sayjal J. Patel, David E. Silverstone, Linda Wedemeyer, Flora Lum. Ophthalmology 1 August 2011 (volume 118 issue 8 Pages 1681-1687 DOI: 10.1016/j.ophtha.2011.04.015)