I've been asked how I do housecalls with EMR. I did a housecall on Wednesday.
I review the chart before going. I print the CPP (which has the patient's date of birth, health card number, address and phone number on top). I take that to the housecall; it helps to have the address, I don't have to copy it from the chart.
During the housecall, I may make a brief note on paper; when I get back to the office, I document the visit in the EMR. For simple prescriptions, I give the patient a written script (entered in the EMR later); for more complicated prescriptions, I ask for the pharmacy number; I print from the EMR to fax it in later. I have an ethernet cable in my laptop bag, in case there is internet access where I am going.
On Wednesday's housecall, I had to call an ambulance. It was good to be able to give the ambulance attendants a printed CPP with all the information on it. It would be better if the CPP was securely available on-line when needed, but this can't be done yet.
I found out from a colleague that I can stop the paper lab reports; this does not have to be done as a group. It was was surprisingly easy to do--just two emails and a faxed letter.
I continue to be amazed at the satisfaction that I am getting from the paper Bgone process, and others are telling me the same thing. My consultation room is uncluttered, and my exam rooms are much neater. When drug reps come in, I no longer accept pads of patient handouts; I will take a single page if it looks interesting, and will scan it in later if it is really useful. The reps now manage the sample cupboard, they put the drugs in the cupboard (and never on the counter). A rep came in on Tuesday carrying two cases of enormously over-packaged samples; this was promptly rejected. My practice team is much more conscious of office space usage, and I think I feel more Green.
I've put patient instructions on my saved favourite DI reqs, so that these are always printed along with the req. As well, our Total Joint Assessment Centre has specific requirements for knee and hip XRs; I've saved those as a favourite DI req, so I know that the appropriate XR will automatically be done in the future. I've emailed samples of electronically generated Diabetes Education Centre reqs and MRI reqs to both centres, and have asked if I can use those instead of the scanned standard reqs. If I generate those electronically, they are part of the chart, all the demographics are automatically entered, there is no bad handwriting, and the referral can be tracked. They will have a look and let me know; there is a good relationship between the hospital and family physicians, so things like this often happen.