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    Friday, May 27, 2005

    EMR Update: It's been four months now since my office began using an electronic medical record and I can say with a sigh of relief that I'm beginning to see the light at the end of the data entry tunnel. Twelve hundred of my patients have now been entered into the system. That's 1200 charts I've sifted through and summarized for the electronic record. I'm not sure how many "active" patients I have, (It depends on how you define active. People who have been seen within the past year? Two years? Three years?) but I believe the majority of my sickest - and most densely recorded - patients are now in the system. Which means I should be spending less time combing through charts with each passing day.

    Although the first month of using he EMR was more stressful than I anticipated, my staff are now EMR boosters. They no longer have to put a patient on hold while they go searching for their chart. They no longer have to call in prescriptions to the pharmacy (I fax them), and they no longer have to refile charts at the end of the day. No one's chart is ever lost. I've heard them tell each other they would never want to go back to the old paper-based system.

    I'm liking it, too. Documentation is much easier - and faster - with the computer system than it was with paper. So is refilling prescriptions. The patient's previous prescriptions are kept as a list in the computerized record's summary database. I just have to click on a pull-down menu to get the stored prescriptions, select the one that's needed, then fax it directly from the record to the pharmacy. It's a much faster process than the old way, which involved writing out the drug name, dosage, instructions, quantity, and refills and then passing the note back to my staff who then had to call the pharmacy and either remain on hold while the pharmacist came to the phone or recite it into an answering machine.

    Although scanning incoming paper from other doctor's offices, diagnostic centers, the hospital, and labs was initially a monunmental problem, we've got that solved now, too. I've blogged about the scanning dilemma before, but to recap, I bought a Brother MFC-8840DN, combination scanner/fax/copier hoping it would not only replace three machines with one, but that it would also make it possible for the staff to scan data into charts quickly using any computer. It wasn't until after I purchased it, however, that I discovered its document feeder doesn't work with Windows XP. It only works with earlier Windows systems. The flat bed scanner works with XP, but it's a much slower process. We contacted Microsoft who said it was Brother's problem to fix, but it provd impossible to contact anyone at Brother. I didn't want to add to the stress level of my staff, who were having trouble the first four to six weeks adapting to the new system. So...for the first two or three months, I was doing most of the scanning myself with a small portable scanner that I could easily transport from the office to home. I was spending all of my free time scanning and it was driving me nuts.

    I finally got wise and connected an old computer that runs Windows2000 to the Brother Scanner. It's set up next to the scanner/fax/copier (which also happens to be where the incoming postal mail goes) so the staff can easily scan incoming paperwork as it arrives. I was afraid they would resent the extra work, but they don't at all. Now that I'm faxing the prescriptions, they have the time to do it. And it's just as easy to scan the papers into their respective charts as it was to sort through them and put them in appropriate folders for my review. It's also a noticeably faster process using the document feeder - even if just a series of one-page results are being scanned into different charts. What used to take me an hour with the portable scanner takes about twenty minutes with the Brother's document feeder.

    Which means - I hope - that I'll be having more and more free time in the evenings and on weekends than I've had these past few months. It was quite a slog for a while, but I'm finally beginning to feel it was worth it.

    posted by Sydney on 5/27/2005 09:00:00 PM 0 comments


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