Thursday, July 20, 2006

Shared Electronic Charts

Having the 9 physicians in my group practice out of 7 different offices gives rise to some interesting possibilities.

I have a patient with borderline hypertension. Her daughter is a Practice Assistant in the office of a colleague in my FHN, and volunteered to periodically check her mom's pressure at her office. My patient consented to have her daughter access her chart and enter weight and BP electronically. So now I have weight and BP entered remotely; I sent an internal electronic message in the EMR telling my patient's daughter how to generate tables and graphs of BP, and I can see those as well. I'll make a flowsheet so that we can follow weight and BP together. The EMR logs and tracks who enters data.

As well, I do shared prenatal care with a colleague. I follow patients until 24 weeks of gestational age, and she takes over after that. This week, I sent an internal message to staff in her office that electronic lab and ultrasound results were available. They were able to view the results on our common electronic chart (no faxing).

Looks like you can both enter data and look at information in a shared electronic chart. Several colleagues in my FHN are in our palliative care group, and a shared chart could be especially useful in this setting. We'll need some good, common sense rules to protect patient privacy while ensuring that people in a patient's circle of care have appropriate access.

A new family medicine resident came to my practice this afternoon. I gave her the spare laptop to use while in my office; it had been configured to access my wireless network and the remote server. We talked about how to use the EMR, and I showed her how to enter clinical notes and prescribe medications. We also discussed how to navigate the EMR-based chart. By the end of the day she started to become more proficient at this, and had done several prescriptions. I think taking over an EMR that is already used in a practice will mean a shorter learning curve.


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