title: Development, implementation and benefits of a rheumatology-specific electronic medical record application with automated display of outcome measures.
abstract: OBJECTIVE
  To make a rheumatology-specific electronic medical record (EMR) application for easy clinical data entry, automated display of outcome measures in real-time that generates well laid-out print-outs; and provides an easily retrievable database for clinical analysis and research.
  
  
  METHODS
  Highly labour-intensive 'MS-WORD ' template used earlier provided the basic framework for developing rheumatology-EMR applications. The authors, a rheumatologist and a soft tissue surgeon with expertise in developing medical software, successfully created a rheumatology-EMR application over a period of 2½ years using the same basic flow of work as used in the old 'MS-WORD ' template.
  
  
  RESULTS
  The resulting EMR application form has a standard medical record documenting demographic data, complete diagnosis, appropriate dates, visit number, disease status, history, physical examination, investigations, follow-up and prescription page (with automatic updates wherever applicable). Mathematical calculations required for outcome measures (DAS, DAS28, CDAI, SDAI, AS-DAS, BASDAI, BASFI, BASMI, SLE-DAI and others) are embedded in the software, with automated updating as the examination of the musculoskeletal system proceeds in real time. Following implementation of this EMR application, more patients are being seen, patient waiting lists have been reduced; more time is available for academic and teaching work, without compromising the quality of notes, and print-outs for patients. Data retrieval has simplified clinical research with increased numbers of abstracts being presented and research papers being published.
  
  
  CONCLUSIONS
  Healthcare workers with understanding of the basic principles of computers and softwares should interact with software engineers who are either themselves medical doctors or are familiar with the workflow and clinical evaluation processes to create an efficient speciality-specific EMR application.
authors.affiliation: A&R Clinic for Arthritis and Rheumatism and Department of Rheumatology, ISIC Superspeciality Hospital, Vasant Kunj, New Delhi, India. anand_malaviya@yahoo.com
authors.forename: Anand N
authors.initials: AN
authors.lastname: Malaviya
authors.forename: Shashi B
authors.initials: SB
authors.lastname: Gogia
mesh_terms: D000554:Ambulatory Care Facilities; D001071:Appointments and Schedules; D001331:Automation; D003299:Cooperative Behavior; D003626:Data Display; D057225:Data Mining; D011307:Drug Prescriptions; D057286:Electronic Health Records; D006305:Health Status Indicators; D006751:Hospital Information Systems; D006782:Hospitals, Special; D006801:Humans; D007194:India; D033183:Interdisciplinary Communication; D011237:Predictive Value of Tests; D012216:Rheumatic Diseases / Q000175:diagnosis / Q000188:drug therapy; D012219:Rheumatology / Q000379:methods*; D012985:Software Design; D017748:Time Management; D014584:User-Computer Interface; D014850:Waiting Lists; D057188:Workflow