Sheri Ross, Clinical Director, MD Physician Services Software Inc.
The benefits associated with the use of electronic medical records (EMR) systems are commonly based on physicians’ reports of their personal experiences—which offer reflections of real, living experiences and are extremely valuable.
One of the most commonly reported benefits is that EMR “saves time”—even though this is often not realized at the time of implementation, because, as with learning anything new, a time investment is required to learn the new skill and to become comfortable with its use. Beyond that initial learning period, however, the potential is there for realizing significant efficiency gains. These time-savings are so quickly consumed by other aspects of the care process, however, that, within a very short time, they may no longer be recognized. This article highlights several efficiency aspects that are provided by the use of an EMR system, and the associated benefits.
Physician and physician office efficiency gains are realized in a variety of ways via EMR software—including readily accessible and retrievable patient information, improved communications among members of the care team, and electronic access to reference materials. In current practice, it is common to see some level of automation within the physician office setting, even if that does not extend to patient record information. Typically, scheduling of patient appointments and physician billing are supported by electronic systems—and it is possible to realize significant office efficiency gains with this level of automation. In order to electronically schedule patient appointments, the system requires the user to record basic demographic information for the patient, including name, address, telephone numbers, age, gender and emergency contact information. Even this most basic level of information capture allows for the generation of lists, based on age, gender, primary care physician, geographical dispersion of patients, or any combination of the above. This level of understanding about the patients cared for in a practice is more than simply interesting—it can provide valuable information for use in planning specific programs or focused service offerings, such as immunization coverage for children or flu vaccine coverage for seniors.
Extending automation beyond the functions of scheduling and billing to full EMR capability provides additional benefits, in a variety of ways, for both the physician and the other members of the care team. Paper records can be accessed in only one location at a time, and a great deal of time can be spent in simply trying to track down the location of a single record. Once these records become automated, however, they can be accessed by any member of the care team, from any room or location in the office where a computer exists, at any time. Within the electronic patient record, the physician can readily access all information—including information derived from external sources (such as laboratory results), along with other information that can be viewed in a variety of ways and formats to support physician review and clinical decision-making. The ability to hover over a data point in a graph of lab data, for example, and to see—displayed in a tool tip—the treatments and medications the patient was prescribed at the time a lab was completed is a very helpful tool in interpreting the information at hand. By being able to collect information from various parts of the patient record and then presenting the results in a graphical display, the physician is enabled to readily identify trends and areas that may require further monitoring or follow-up.
The ability to easily send a message to other members of the care team regarding further actions for patient care or follow-up can help prevent items from “falling through the cracks”. Examples include a physician message to the chronic disease management nurse to provide additional training on some aspect of the prescribed care regime, or a note to the administrative staff to schedule a consult with another physician. The ability to record the information as part of the care delivery process, and to have a legible record of the interaction for follow-up, serves to improve the overall experience for members of the care team and, ultimately, the patient.
Another benefit that can be realized, in a clinic where two or more physicians work together, is the ability to assign coverage to another physician during a planned absence (such as vacation). This feature enables the physician who is going to be away to assign his or her patients to another physician for the duration of the absence, thereby providing the covering physician with full and unrestricted access to the information contained in the medical records, so that patient care continuity can be maintained. Access to the full spectrum of information supports the covering physician in evaluating the needs of the patient and in making decisions about care; it also serves to avoid unnecessary repetition of diagnostic or evaluative studies.
Clinical decision support tools are a component of most complete EMR systems—and they provide an extremely valuable benefit to the physician. These support tools are integrated within the EMR system to provide information when prescribing, and at the time decisions are being made—examples may include alerts regarding drug-drug interactions, drug-condition interactions or drug dosing information, among many others.
The ability to readily launch a variety of reference resources from directly within the EMR system is another benefit. The information accessed is current, and search capabilities within the linked tools result in information being provided within mere seconds of making the electronic request.
The EMR efficiency features described in this article are provided by PS Suite® Software, and will be demonstrated in the first of three webinar topics to be presented in March and April 2012. Webinar information is available on the PS Suite Software website at md.cma.ca/practice-management/ps-suite-software/.
® Registered trademark of the Canadian Medical Association, used under licence.