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Software creates 'dashboard' for diabetes docs

This article first appeared in the St. Louis Beacon, Jan. 30, 2012 - Some doctors are beginning to discover a downside to electronic health records. Call it EHR overload. It refers to instances when physicians have so much medical data at their finger tips that they are overwhelmed and have trouble finding what they need to make quick decisions about treating patients.

"Electronic health records are actually giving us a lot of data," says Dr. Richelle Koopman, associate professor of family and community medicine at the University of Missouri School of Medicine in Columbia.

"But we've gotten to the point where there is actually too much data. We need to organize it in a better fashion to make it useful. That's what we've tried to do with the dashboard."

The "diabetes dashboard" is a godsend for doctors, helping them better manage medical information for treatment of diabetics, Koopman says.

Some doctors treating diabetics have to click the mouse back and forth up to 60 times to find and read all the relevant electronic records about a patient. The dashboard gathers all the data on a single screen with about three mouse clicks.

"Finding all this information in the medical chart (used to) take doctors an average of five minutes. The dashboard pulls all this information together ... (in) one minute. In other words, we're saving the doctor four minutes, and if you've got a 15-minute visit, that's a lot of time."

That extra four minutes, she says, gives a physician more "quality time talking to the patient instead of (having) your nose in that chart."

The dashboard software collects data common to many health conditions and chronic illnesses, but the main focus is on delivering better treatment for diabetics.

Created by the medical school in 2008, the dashboard is now marketed nationally by Cerner, a health information technology company based in Kansas City. Cerner offers the dashboard software to health providers who use one of its EHR systems. No information was immediately available on how many hospitals use the dashboard. There are competing products on the market.

Koopman says a university study of the dashboard suggests it can lessen medical costs by helping doctors avoid ordering needless medical tests.

"We created charts similar to patient charts with a similar amount of information," said Koopman who worked on the dashboard project. "Some of the information that doctors needed was buried. Some of our physicians found all of the information, and some of them couldn't."

In addition, she says, some doctors wrote down incorrect information when using the old system or failed to record the most recent results for some tests as they flipped and searched different computer screens to find information.

"That can happen when you're jumping around trying to find stuff," Koopman says. "When you are floating around through multiple screens and clicking and clicking, there's actually a lot of what we call cognitive load. It actually takes up part of your brain so that you make more errors. But the biggest category of errors was that the physicians didn't find stuff. "

Even with the potential information overload, Koopman readily acknowledges that electronic medical records are important in health-care management. She remembers the days when she became a physician in 1993. Paper records were standard and doctors scribbled notes on paper, leaving it to someone else to compile the data into records.

"That's one of the valuable features about the dashboard. Nobody has to key in information because the software is pulling together information already in the patient's charts. It helps physicians coordinate care on a single screen. This streamlines and improves care at a lower cost."

Funding for the Beacon's health reporting is provided in part by the Missouri Foundation for Health, a philanthropic organization that aims to improve the health of the people in the communities it serves.

Robert Joiner has carved a niche in providing informed reporting about a range of medical issues. He won a Dennis A. Hunt Journalism Award for the Beacon’s "Worlds Apart" series on health-care disparities. His journalism experience includes working at the St. Louis American and the St. Louis Post-Dispatch, where he was a beat reporter, wire editor, editorial writer, columnist, and member of the Washington bureau.