Friday, February 29, 2008

Helping my practice partner start the transition

My partner has been away in the past week. I had a look at his computer, and made sure that he has access to all the scanned documents on the front computer. These now include all the requisitions for programs at our hospital, and all the documents that I had previously scanned.

As well, I configured things for him within the EMR software. He has access to all the handouts, to outside links for patient education, to pre-made DI requisitions, and to ready-made consult requests. Many of those things (such as our phone book) can be shared, but some cannot. It took me about an hour to organize this, and I consider it time well spent; this work will ease his transition. We sent an email to notify the labs this morning, and the first electronic results already came in this afternoon. Things move much more quickly now than they did when I started. As of today, my partner has hybrid charts; he will need to decide how quickly he moves to fully electronic--that is where the biggest gains are.

I think I will put in some medications favourites for him; I have a list of drugs that I commonly use, and I will ask him to pick some. Maybe I will sit with him periodically at lunch, and we'll have a look at things together.

I sent him an e-message while he was away, and made a dummy chart for him to practice on. The flow sheets are programmed and are ready for him to use; I have a pretty good selection of useful templates as well. I have profiles and billing short cuts that are ready to use.

Setting all this up made me think about how much I now know about EMR, and how much work I did. When you first start, most of this is just not in the application; it can't be, since practices differ, and different physicians use different diagnostic facilities, have different referral patterns etc. I had to put in things at the beginning without really knowing how the software works. In retrospect, it was actually easier for me to start by myself, and to have a hybrid practice for a while. The new physician who joined me helped me to work out the bugs of having several physicians in the office on EMR instead of just one. She now requires no assistance from me, and is using many of the advanced features of the EMR, after only three months. I think things actually worked out well.

My secretary has started scanning in the paper charts for my partner's deceased patients. These are going into the networked hard drive at the front, same as mine. We have made new folders for his patients. He had a look at several charts from his computer, and I think he was happy with the excellent quality of the scans. We showed him how to use the "pages" tab on the left side of the pdf file (this produces thumbnail pictures) to quickly find what he is looking for. We have started shredding the paper charts that have been scanned in.

He now has a lot of work to do; all his CPPs will need to be entered in. I think he is considering hiring a student to do part of this work, which is not a bad idea. I will talk to him about coding his ongoing medical conditions in the paper CPP; he can enter the ICD code besides each condition, and that will help the student with accuracy. He will need to review each CPP that was entered.

There is still some uncertainty about when we move to the big office; I think this will most likely be in late Fall. It will be tight for him to complete the transition before the move; I have not allocated any space for paper chart storage. Starting now is not too early.


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