Monday, October 26, 2009

Melissa Young, MD: The Search is Over, Now the Fun Begins

In my previous posts, I wrote about the search for the perfect EMR. Did I find it? Wait, wait…I can’t type while I laugh hysterically. The short answer is “no.” The EMR I chose is not perfect. Oh, I still think that compared to the others I looked at, it is far and away the most appropriate choice for me. But, perfect? Certainly not.

And I say this after having spent an inordinate amount of time trying to make it work the way I would like it to work. I had the luxury of being able to “play” with it before I actually had patients to see. I was even able to use it remotely before I had my office computers. Heck, even before I had an office. This was courtesy of my VAR (don’t ask me what it stands for, all I know is that they are the go-between between me and the EMR company). They were able to provide me with remote training, and I was able to create templates while I was getting the office ready.

But there is a huge difference between theoretical answers to questions in a template, and the long rambling stories my patients like to tell. And since there were very few endocrinologists using the software, the pre-built plan templates were missing a lot of the labs I commonly order (and the ones I uncommonly order).
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I must say I have been pleased with my ability to create a consult letter (one that meets Medicare’s requirements – although soon it may not matter if they get rid of the consultation codes) minutes after seeing a patient (sometimes while the patient is still checking out at the front desk).

I also like being able to instantly find out what “that pill (I) stopped” was, even from home. And when the prescription faxing function works, that’s great, too. Only problem is it’s been hit and miss with that. I’ve been telling patients to call the pharmacy before they head over to make sure the prescription went through.

And although I had heard patients complain in the past about other docs who “hide behind that damn computer all the time,” it does not appear that my patients mind me tapping on the screen. My tablets are small enough that I can look over the screen at the patient and maintain eye contact. As an aside, I did have a tough time finding a computer cart that was small enough to fit in the exam room, sturdy enough to be wheeled around and low enough that people of short stature (i.e. me) could use it while sitting that didn’t cost as much as a small car.

Am I reaping all the benefits of using an EMR? No, not yet. But I can still see the potential. I am working with my VAR to make things work. I am modifying templates as I go along. I am periodically pulling out my hair. And I look forward to the first follow-up patient whose note I can partly write by clicking “past note.” Let’s hope it works.

Melissa G. Young, MD, FACE, FACP, is an endocrinologist in private practice, an assistant clinical professor at Robert Wood Johnson, and a working suburban mother of two in Freehold, N.J. She is a regular contributor to Practice Notes.

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