By STEVE SANDERS, DO
Is Mom at risk of falling?
Electronic medical records (EMR) efficiently capture physician’s keystrokes—yes or no—to this question and tuck it along side other data about our so–called medical lives.The physician’s judgment has to take into account many factors: is the patient elderly and ‘frail,’ do they have an orthopedic or neurological problem causing them to lose their balance, can they get up from a chair without having to use their arms to push-off, importantly do they live alone. Most of the answers to these questions come quickly through discussions with the patient or their family, or by simply observation. Nine times out of ten physicians can predict that a patient will fall before it happens.
Now, the EMR owns this critical piece of information. But the next most obvious question, as many of you can guess, seems clear: now what?
Ideally by clicking yes, a sequence of events occurs; (a) Home health receives an electronic message requesting a patient safety visit. Specially trained home health nurses look for loose rugs that may slip out from under the patient, extension cords waiting to snag an unsuspecting foot, toilets without support for getting up and down, or the need for an electronic alert system bringing help quickly (b) An alert goes to the patient’s pharmacy requesting a drug–drug interaction report, detailing which drugs interfere with each other causing precarious side effects. Alerts also goes to the primary physician highlighting which of the patient’s medication tend to cause problems in the elderly (c) Schedules an appointment with physical therapy for balance and strengthening exercises (d) Arranges for a visual examination and hearing test, after checking on previous tests. These steps become placed into motion within a nanosecond after clicking ‘yes.’
