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IBM helps doctors add notes to patient electronic records

Submitted by douglas cooley on March 5, 2014

Health care providers are rapidly ditching paper-based patient medical records for electronic health records (EHRs).  If you’ve visited a doctor’s office recently, you know what that means. Your physician enters the exam room, chats with you, and maybe exams you. The doc then turns to a keyboard to enter data into fields on a computer screen. Your health profile gets electronically updated right then and there.

There’s a big upside to having this digital version of your medical history.  It makes your diagnoses, lab tests, allergies, current prescriptions, and other bits of health information easy to share and manage. It allows for coordination of your care between clinicians. It helps control the administrative cost of delivering care. All of these are essentials in smart health care and certainly in smart cities that are proactive about enhancing livability for their residents.

But there's been a problem capturing certain types of information in EHRs. While EHR data fields accept “structured” information like your latest blood pressure numbers, a physician’s notes are not so easy to incorporate into a record. Notes are the “unstructured” information that a physician feels is important to capture. A doctor may write a note, for example, that flags a significant family issue that impacts a patient’s health.

SCC Lead Partner IBM has developed a software solution that addresses this deficiency. It’s IBM’s natural language processing technology. The technology enables doctors to upload their text notes to be translated into discreet data fields that can be integrated into today’s EHRs.

“To continue to evolve the meaningful insights that are gained from the EHR, it is important that patient records include a complete and accurate snapshot of each patient,” Dr. Michael Weiner, IBM’s Director of Healthcare Strategic Solutions, writes in A Smarter Planet Blog. “As we have often suspected, there is a great deal of rich and meaningful information within doctors’ notes, which contains some of the most valuable information on a patient’s condition.”

Indeed, advancing EHR technology is an important component of the emerging “smart health” discipline. Health care organizations are learning how to gain greater insights from EHR data and develop strategies that can positively impact the well-being of individuals and their communities. The Smart Cities Readiness Guide explores EHR and other key health care technologies in its Health and Human Services chapter. The Guide is available at no cost to members of the Smart Cities Council. If you have not yet joined, take a moment to complete a one-time free registration.