Sunday, June 03, 2007

Managing change in my group

We had a FHN meeting on Tuesday to decide on further EMR implementation steps, as we continue to be at various stages in the process. The government has now started to provide a subsidy to hire a group administrator. We decided to hire one of my staff members, who is particularly adept at the EMR, to help us along.

As well, summer is a good time to get additional help, because of the availability of university and high school students. We have hired the first student to help with some data entry (finishing the roster lists; entering dates of preventive services). We decided to pay for the student out of group funds. Once the data is entered, our group administrator will manage functions such as mail-outs for drug recalls or problems, and on-going maintenance of our mailings for preventive services. The group administrator will also work with staff at the various offices to make sure that things like scanning or internal email are working smoothly.

We also agreed to use group funds to hire someone to do preventive computer maintenance; we have to decide exactly what that means. I think it probably means cleaning the computers (there seems to be a lot of dust accumulating in the back, where the fan is), making sure that the Windows updates are updated, making sure that the anti-virus system works. I found some information on this on the Microsoft website.

My lab sometimes makes mistakes and runs the wrong tests. I know this because I order labs in the EMR, and a copy of the req is automatically kept in the record. I see a Hepatitis A antibody coming in from the lab, and the req clearly shows I requested a Hep B antibody. I can't really order labs electronically; we use a copy of the Ontario lab form. This is printed and signed, and goes to the lab along with the test tubes. This means that someone has to manually enter test requests at the lab end, and it also means that there are data entry errors. Eventually, I would like to transmit orders electronically directly to the lab, or if this can't be done, have the order bar coded on the test tube. The risk of data entry errors is just too high with our current ordering system. I don't like the Ontario lab forms; having it means that the whole requisition is checked off as done when results come in. I think it would be better to have each test cross checked electronically, which means electronic lab ordering (and not an image of the current paper-based lab req on my EMR). I also need to have a pop-up on demand tell me which test tubes and how many test tubes I need, to avoid the lab return a message that a test tube wasn't sent and therefore a test was cancelled. I can't always remember that I need 1 grey top, two purple top and 1 tiger top test tubes when I draw blood. The system should help me, but it will need true electronic lab reqs to do this, not a replica of a paper-based system.


No comments: