MissiveEMR

MissiveEMR is an iPad-based electronic medical record (EMR). It was designed at the University of California Irvine School of Medicine as an EMR for medical students who provided free care to groups in need. As such, it selectively implements key features while avoiding the heavy crust of most commercial EMRs. This has resulted in a product that is very simple, intuitive, and still powerful.

Use of the app is subject to the approval of each group's electronic medical record director.

Key Features:

- Full offline support: Using a custom RESTful API, each iPad can write notes and view past records while offline, like when they are used in clinics in Mexico with Flying Samaritans.
- A central server stores the master database, with each client downloading it and then synchronizing changes to/from it.
- After returning to WiFi or 3G/LTE coverage, the app sends notifications that changes need to be synchronized.
- Pharmacy Database and Inventory: A complete database and inventory system allows organizations to quickly enter their inventory and providers to dispense medications they know they have, instead of stumbling around the pharmacy each time, desperately searching for something within the class they wish to dispense.
- Note Writing: The note composition interface is a clustering of both empty text fields and more advanced controls, leaving things simple that ought to be simple and when appropriate, allows faster and intuitive information entry.
- Review of Symptoms Interface: Using just a quick tap or two of your finger, documenting the ROS has never been easier – and it looks great when output.
- Spanish translations: A quick slide of your finger brings up Spanish translations of key questions. Siri even teaches you how to say them!
- Note output: Once a note is completed, an output is generated which is dense, but still easy to read, and easily exported as the need arises.
- Copy Forward: Import important information forward, like allergies, medications, and past medical history.
- (Importantly, none of the physical exam, HPI, A&P, vitals, etc, may be copied.)
- Deletion: Both patients and notes can be deleted, but all data is stored on the central server, allowing retrieval to preserve documentation and in case of any mistakes.
- Security: The app itself is password-protected, with an automatic lockout. Data on the iPad is protected by native iPad encryption. Passcoding the device is highly recommended. All communications between the iPad and the server is SSL encrypted with certificate pinning for added security. Data on the server is encrypted at-rest with AES encryption, and passwords are salted and hashed.
- Signing: Each note can have author(s) and cosigner(s) designated, allowing multiple medical students to edit a note. After they sign, an attending physician can review the note, edit as necessary, and then co-sign it.
- For review by other parties, synchronization to the server, and therefore an internet connection, is required.
- Versioning: An advanced versioning system for notes is built right in, so that after signing, a note can still be edited, while the old version is preserved and can easily be reviewed.
- Dental: If requested, a set of dental questions is available in the note interface (and can otherwise be hidden).
- Coming Soon: Putting the “Missive” in MissiveEMR, and other features by request.

For more information, please contact missive@stephenschale.com.