Ways to improve the CERNER EMR

There are a lot of reasons why ppl hate EMRs. I hope to collect some of the biggest problems and work with the IT department to streamline whatever views can be streamlined to improve charting efficiency and accuracy. In turn, I expect this to reduce burnout amongst residents, attendings, and medical students (who unfortunately lose 1-2h of sleep and study time daily pulling numbers that could easily be done by a computer), improve patient outcomes by allowing all members of the team to spend more time thinking about data rather than collecting it.


  • Some ideas I proposed to the director of IT at a hospital I’ve worked at
Over the past few months, I have gained a solid understanding of the rounding process and the worksheets we use from the Discern Reporting Portal. While the current sheet is very good and useful, I have ideas for how to improve it. Would like to schedule a meeting to discuss some of the ideas listed below. Here are some of my thoughts:
– Re-position some of the info on the sheet by systems
– increase the types of data that are shown on the surgical workflow sheet
— more detailed information from the flowsheet: JP outputs (24h/12h), wound vac, ostomy, bowel movements, NG/OG tube
— a full list of meds in the -24h, including dose and schedule
— PRN meds -24h
— transfusions -24h
— a graph of vitals -12h (HR,MAP,SPO2,TEMP, Urine output)
— any nonstandard labs resulting in -24h, with trend (e.g. Factor Xa, CRP, Procal, Autoimmune labs…)
— micro: which organisms in the cultures
— nutrition status: NPO, TF, RD..
— when labs are older than 12h, they should be marked in such a way (e.g. underlined, or *)
Additionally, when writing notes, I’d like to have a dotphrase that I can customize to pull the “last N values of a specific lab by name”
for instance, the phrase lab_nX_Labname which can be customized for all labs listed: lab_n10_CK or lab_n5_Lactate
  1.  similarly, a way to pull data from the flowchart into the note: ..flowsheet_n10_Q4_Drain-JP-left
When we talk, I’d be happy to show you examples of the notes we’re collecting by hand. It takes ~10m/patient to collect this info x 7pts = 70m of writing numbers. Additional time is required to synthesize this info with respect to o/n events, notes from other services. If we could create one view that shows all this info in an organized way, or alternatively, reformat the worksheet to show this info, we could use that saved time to do better analysis.
  • Another set of amazing insights… many of these are still valid 8y after the original post
    • https://www.reddit.com/r/medicine/comments/zxo6v/how_would_you_improve_cerner_powerchart_emr/


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