What is EMERSE?

EMERSE is the Electronic Medical Record Search Engine. It was designed to work with the free text (unstructured) clinical documents in an electronic health record (EHR) system. Most importantly, EMERSE was made for regular users, not those with IT or informatics expertise. It was developed at the University of Michigan in 2005 and has been continuously improved and updated since then. EMERSE has been used to support a variety of tasks, including clinical and translational research, internal quality improvement and quality assurance initiatives, as well as for hospital operational support tasks. It has been used very successfully by the billing and coding team for complex case reviews, improving reimbursement rates by nearly $1 million per year. The software is used routinely by our compliance office, risk management, and infection control departments. It has also been used in the clinical setting, to support rapid data retrieval to answer clinical questions as well as to reduce the burden of prior authorizations, required by many insurance companies. EMERSE has also been used to support hundreds of research projects, resulting in many peer-reviewed publications.

EMERSE can integrate documents from multiple sources. At the University of Michigan, EMERSE has tens of millions of documents, including those from our original, homegrown EHR system, CareWeb, as well as newer documents from our replacement vendor EHR, Epic. EMERSE was designed to be vendor-neutral--as long as you can get your documents out of the system, EMERSE should be able to search through them. We've even created an interface to move cohorts identified through the i2b2 Workbench directly into EMERSE for further searching of their free text notes.

EMERSE was created with support from the University of Michigan Comprehensive Cancer Center, the CTSA-supported Michigan Institute for Clinical and Health Research (MICHR), the University of Michigan Health System through the Medical Center Information Technology (MCIT) Department, and the University of Michigan Medical School through the Medical School Information Services (MSIS) Department. We are making EMERSE available at no cost for academic use, and for a reasonable fee to support ongoing development for other uses.

EMERSE provides features to help get your work done quickly and accurately. For example, the tool includes a large list of synonyms and related keywords to help you expand your search even if you don't know the right terms to use. This includes a large collection of trade and generic drug names, acronyms and abbreviations, and other wording variations including spelling errors.

Screen capture from EMERSE showing expansion terms for the word "cigarette".

EMERSE also provides intuitive and novel ways to visualize the search results, to help you focus on the information you need. For example, search results can be viewed as a 'heat map', showing the density of documents with a search hit, as well as what we call the 'mosaic view' which shows which specific terms appear for each patient in the search results.

In this 'heat map' style overview, each cell is shaded depending on how many documents contain at least one of the search terms. Every row in this view is a patient, and every column is a document source.

The 'mosaic' overview provides more high-level details, showing which specific terms appear for each patient based on the color-coding of each term. For example, in the first row of results, above, the MiChart cell contains search results for 'cardiac' (yellow) and 'chest pain' (light blue).

The 'summaries' view provides text snippets from documents for a patient, allowing for rapid review of the highlighted keywords in their context. The complete document can be brought up by clicking on a row of interest.

The 'documents' view allows users to view the original clinical document, with keyword highlighted inside them to allow for rapid identification of the areas of interest.