Once again, Martin, let me make a comparison of Epic to AC. One of the big things demanded here is that we add an encounter problem to the main "Problem List". We actually are monitored or "graded" as to how often this is done. So, with every encounter you have a discreet encounter problem list which then, by simply clicking on an arrow moves a problem into the main Problem List. Because we are scored on how often this is done, the main problem list is overrun with things like "foot pain" or "Need for screening for prostate cancer". Fortunately, one may, at a later date resolve those non-chronic problems and clean up the list. Unfortunately, few of the numerous users of this mega medical complex take the time to resolve problems and so the job is left, it seems, to those PCPs like me who cannot stand looking at a cluttered, dysfunctional Chronic Problem List to clean it up. I spend countless clicks removing items that others (usually a specialist) add. But, at least I can remove them.
Secondly, for every problem in the chronic problem list, there is a comment section where we can indeed add helpful information such as "Seizure Disorder...seizure free since 2012, normal brain CT 2010, followed by Neurology". Once again, however, very few of the users actually add any comments so the task trickles back down to the PCP who is considered the Medical Home and you end up spending valuable time going through all of the previous documentation over and over again in order to get a good feel for those problems. Since nearly all of my patients are still new to me, this task becomes overwhelming. The EHR has the capability to lessen this task but it demands that all of the users contribute to the helpful placement of the information.
Certainly the large medical community of which I am now a part differs considerably from the smaller practices using AC, but the ultimate goal still remains that any provider reading a patient's medical record should be able to easily retrieve the vital information in as little real estate as possible. Having information such as you suggest (most recent spirometry in a COPD patient, GFR in a CRF patient, etc.) pop up or be incorporated somehow with the problem in the Chronic Problem list would be ideal and would keep you from having to constantly change screens to find it.
