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Charting a Snap with EMR that Sits on Top of Enterprise Systems

Mohseni, Alex MD

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doi: 10.1097/01.EEM.0000471525.83333.20
    Watch a charting demo video (above) of Forerun in action at

    As technology advances at an exponential pace in our regular lives, with services such as Google Now magically predicting what you need before you realize you need it, the languid evolution of enterprise EMRs becomes ever more acutely painful.

    But I would argue, and I believe there is evidence to support, that not only are these enterprise systems difficult to use, but they contribute significantly to provider frustration, burnout, and reduced productivity. We interact with our EMRs more than perhaps any other tool or interface, even the phone, the stethoscope, or humans. How and why we as physicians have not been able to demand more functional user interfaces is astounding. Why have we not raised our voices together in protest? Why is this issue nowhere on ACEP's agenda?

    I recently learned of a solution called Forerun ( that offers an emergency medicine EMR that sits on top of your enterprise EMR for clinical documentation. Forerun is an easy web-based interface that allows emergency physicians to document their note, pull in vitals, lab, and radiology results, and output a beautiful and easy-to-read note into their enterprise system quickly and easily.

    What really stands out with Forerun is their integrated clinical decision support. They are working on building support for detecting high blood pressure and automatically prompting the physician to document the requisite PQRS measure and include high blood pressure information in the discharge instructions.

    This is pretty basic stuff — an easy way to support physicians — but most EMRs don't do anything of the sort. Why not? The whole point of digitizing health data is so that computer systems can help us analyze and act on it. Digitalization in and of itself doesn't solve anything other than handwriting recognition.

    It's not perfect, and it lacks computer order entry (you still have to use your enterprise system for that), but Forerun is a great leap forward in usability for physicians, and I hope it is just one of many solutions to develop in the near future to help us perform our jobs more easily.

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