Sunday, February 05, 2006

Doing things differently

The EMR will allow me to do things differently. How differently will depend on what me and my staff decide to change; it won't happen by itself.

One of the things I've been thinking about doing is giving patients a printed summary at the end of their preventive health visit. I know that patients cannot remember everything they hear in the exam room. For example:

"Exercise improves health. I recommend you walk at least 4 times a week, for a minimum of half an hour. Please write down
When you will start:
What time of the day:
Which days of the week:

I recommend you lose about 10% of your weight (xx lbs). Eat smaller portions, more fruits and vegetables, less fried foods and less salt. If you have hypertension, the DASH diet works; it can be found at

Quitting smoking will improve your heath. Please use the information booklet I gave you. The smokers' helpline number is 1-877-513-5333."

I could make a template like that, with checkboxes that I tick off on the tablet. Once I've done a couple in my practice, I probably will get very fast at it, and the printer is right there in the room. I'm already printing information for patients, for example, ASA for heart disease.

One of the things that can be automated in the office is the vaccine fridge temperature logs. Dr. Jim Kavanagh, who is a family physician in Cambridge, Ontario, and a VP at Practice Solutions Software has found a way to do this in his office. Dr. Kavanagh says:

"I use a Hoboware temperature recording device in my vaccine
fridge. It is connected by a USB port to a nearby computer.
It records temperatures every 30 minutes continually, and
these readings can be downloaded to the computer when desired.
I use one of those cheap temperature displays for looking at,
but nobody needs to write down temperatures.

You can't continually display the temperature over USB because
it sucks the battery too quickly, so we left the cheap
thermometer attached, but nobody needs to write down temperatures

I have been doing this for 18 months and it works well. Public
Health here is quite pleased.

You don't need to download the temperatures every day. Once
weekly seems adequate. Glancing at the external temperature when
opening the fridge is good enough for every day."
You can get the Hoboware here. You need the logger, software and cable. Although there is a cost, it will make your staff's life easier because they no longer have to record fridge temperatures twice a day. This is something I will definitely do.



techguy said...

I really like your site. I'll be checking back often to see your progress. It is of great interest since I also have a site for EMR blogging.

One specific thought on this post is that you could also email these type of things to someone. Saves paper that will get lost, it isn't covered by HIPAA if you do it generic info and they get the information which they could forward or print if they like. Plus, the links are more handy in an email anyway.

Michelle Greiver said...

Thank you. I've been thinking about emailing the links to people; this makes a lot of sense. We do not currently store people's emails in the practice database, but the new system has a field for email address. I think I will ask my staff to collect that information. I can ask people if it is OK for me to send the link to them when they are with me in the consultation room.