Saturday, November 03, 2007

Peer to peer

I have often received requests to visit my practice; I think that there are still so few computerized offices in my area that people want some idea of how the EMR works in a real life setting. I also get requests from physicians who have recently started an EMR, so that they can see how things flow in my office and get ideas for their own practice. I have had visits from people in academia who are interested in the EMR transition.

I recently went to visit Alan Brookstone in BC, and got a chance to tour the recently opened PROOF office. This is a regular medical office, set up for EMR, so that physicians can test hardware and applications in a real setting that mirrors their own practices (waiting room, exam rooms etc). There is demand for this; having something organized and easily available will make it much more accessible.

I don't know if we can get something similar in my area; it will take someone to organize it. In the meantime, I have started passing requests to visit my practice on to OntarioMD. We have the new InfoWay Peer to Peer Network, and it says that one of the things we are supposed to do are "individual demonstrations of Electronic Health Records technology". To me, that means "come see my office". At OntarioMD, we have Practice Management Consultants (PMCs), who help with the process of choosing the EMR and receiving funding. I passed the last request on to my local PMC, and she arranged to meet with the physician's group to discuss things such as the subsidy and what their needs are. Once they are ready, she will then arrange for them to come to my office. I think that this is a much more efficient way to do things, and it also provides my colleagues with much more than a simple visit could.

I wish I could make an organized inventory of work flows that I use. I did not find such a thing, and had to invent many things as I went. I am sure many of my work flows are similar to other physicians'. I was watching my colleague, Dr Stephen McLaren, speak about this subject. The video will take a bit of time to download, but it is well worth the wait. This type of practical, day to day work flow advice is invaluable; maybe we should have some type of document on work flow (paper, or CD or internet based and searchable), with "how to" sections. There are enough power users now that we could have screen shots of different EMR systems so that the document is reasonably vendor neutral; I think it is important to have screen shots so that you can see how it is actually done.

All EMR systems have their strengths and weaknesses. I have been talking to users of other systems, and I am starting to see what those are. It is helpful for us to talk across platforms, because we will then go back to our own vendors and work with them to improve our products. In terms of choosing a system today, my advice is the same as Dr McLaren's: there are enough larger, established products now on the market; do not pick a small vendor--you will be a pioneer, there are no established peer networks for support, and your vendor is more likely to fail.

I am not saying that the cavalry is here to save your implementation; I am saying that there is much more available now than a year and a half ago, when I started. For those of my colleagues at the tipping point of deciding to computerize, your peers who have done it can tell you that the time is now.


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