Architectural choices and challenges of integrating electronic patient questionnaires into the electronic medical record to support patient-centered care

Strategies to deliver guideline-concordant, patient-centered care during office visits sometimes impose conflicting demands on clinicians. One way to help relieve time-constrained visits and to improve the patient-centeredness of care may be through patients electronically self-reporting data that flow automatically into an EMR note for clinician confirmation or editing, relieving physicians of some data entry and rote history-gathering tasks, thus freeing up time to allow clinicians to focus on significant issues and patient concerns while also increasing the likelihood that necessary data are gathered and available for decision-making. We developed a prototype to enable such data gathering and integration into the EMR. The lack of consistent provision of interfaces by vendors for sending data into EMRs and the idiosyncrasies of any particular EMR in the context of a particular organizations IT infrastructure and policies pose architectural choices and challenges that healthcare organizations embarking on such IT projects may need to consider.