A two-day clinical documentation challenge was part of the Medical Records Institute annual conference Towards the Electronic Patient Record (TEPR 2006), held this week in Baltimore. Competing EMR vendors were presented with a simulated outpatient encounter that involved physician and patient role playing.

This year’s challenge was based one of the three clinical scenarios proposed by the Commission for Certifying Health Information Technology. Clinicians representing the participating challengers then had up to seven minutes each to present their documentation strategy and address all the required needs of both physician and patient. Huge screens displayed what was happening on the clinician's PC, while the clinician's partner narrates the process. When finished, the clinician and narrator had three minutes to review the system's output for the audience and to highlight the innovative features of their solution. They also had the opportunity to state the single most important reason that they believe you potential customers should choose their EHR.

After each challenger's performance, the two clinical-documentation experts commented on the system's functionality. Dr. Whitecoat advocated for the challenger, reviewing the system's positive attributes. Dr. Blackhat served as “devil’s advocate,” presenting deficiencies in the system. In addition to speed and ease of use, the nice doctor and nasty doctor looked for: integrated order entry, health maintenance and other clinical alerts, allergy and drug interaction checking, access to useful and authoritative medical knowledge bases, interactive clinical guidance, patient education tools, and a process that facilitates benchmarking of performance measures utilizing widely accepted national standards of disease management.

The challenge allowed TEPR attendees to witness EMR vendors demonstrating their clinical information system for functionality, cost effectiveness and quality. “The idea is for vendors to go head to head so attendees can compare apples to apples,” said Barry Blumenfeld, MD, associate director of clinical informatics R&D at Partners Healthcare System and co-moderator of the event.