Elsevier

Ophthalmology

Volume 118, Issue 8, August 2011, Pages 1681-1687
Ophthalmology

American Academy of Ophthalmology
Special Requirements for Electronic Health Record Systems in Ophthalmology

https://doi.org/10.1016/j.ophtha.2011.04.015Get rights and content

The field of ophthalmology has a number of unique features compared with other medical and surgical specialties regarding clinical workflow and data management. This has important implications for the design of electronic health record (EHR) systems that can be used intuitively and efficiently by ophthalmologists and that can promote improved quality of care. Ophthalmologists often lament the absence of these specialty-specific features in EHRs, particularly in systems that were developed originally for primary care physicians or other medical specialists. The purpose of this article is to summarize the special requirements of EHRs that are important for ophthalmology. The hope is that this will help ophthalmologists to identify important features when searching for EHR systems, to stimulate vendors to recognize and incorporate these functions into systems, and to assist federal agencies to develop future guidelines regarding meaningful use of EHRs. More broadly, the American Academy of Ophthalmology believes that these functions are elements of good system design that will improve access to relevant information at the point of care between the ophthalmologist and the patient, will enhance timely communications between primary care providers and ophthalmologists, will mitigate risk, and ultimately will improve the ability of physicians to deliver the highest-quality medical care.

Financial Disclosure(s)

Proprietary or commercial interest disclosure may be found after the references.

Section snippets

Unique Characteristics of Ophthalmology

There are several characteristics of an ophthalmology practice that impact clinical workflow and data management requirements, all of which affect the optimal design of EHR systems. First, ophthalmology is both a medical and surgical specialty. Surgical procedures generally occur either in the office or in operating rooms, and medical clearance, if performed, usually are carried out by nonophthalmologists. Thus, EHRs must support documentation in, and transitions between, the office and

Essential Ophthalmology-Specific Electronic Health Records Functions

Based on the factors above, a number of EHR features are important enough to be considered essential for ophthalmic care (Table 1). Absence of these features could affect adversely the ability of ophthalmologists to provide safe and efficient patient care.

Other Ophthalmology-Specific Electronic Health Records Functions

Based on the factors above, there are other features that often are believed by ophthalmologists to be lacking in many EHR systems that are now commercially available (Table 1). Many of these are functionalities that physicians have become accustomed to while using traditional paper-based records. Although EHRs provide many important advantages over traditional paper-based records,17, 18 the authors believe that absence of the following features will limit the ability of EHRs to achieve their

Standards for Data Representation and Exchange

Interoperability is an important concept, representing the ability to exchange data freely among information systems and devices, regardless of the vendor or brand. This will create opportunities for important advances in medical care, data accessibility, clinical research, disease registries, and public health. Even for ophthalmologists who never exchange patient data for referral or consultation outside their practices, interoperability within their practices is required for communication

Future Directions for Electronic Health Records Systems in Ophthalmology

Technological advances and information management challenges are creating stronger incentives for ophthalmologists to adopt EHRs. Meanwhile, federal initiatives are creating rules for the meaningful use and formal certification of EHRs, along with both the incentive payments for physicians starting in 2011 and reduced payments for lack of adoption starting in 2015.7 The authors hope that this summary will help ophthalmologists to identify important features when searching for systems and will

References (22)

  • Key Capabilities of an Electronic Health Record System

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    Manuscript no. 2011-417.

    Financial Disclosure(s): Dr. McCannel is a consultant for Savvient, Inc. and has some equity in Savvient Inc.

    Supported by departmental grants from Research to Prevent Blindness, Inc., New York, New York (MFC, MVB, MCL, CAM). The sponsor or funding organization had no role in the design or conduct of this research. MFC is an unpaid member of the Scientific Advisory Board for Clarity Medical Systems, Pleasanton, California. The opinions expressed in this paper are those of the author and do not necessarily reflect the views of the Indian Health Service.

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