Friday, April 04, 2008

Giving back

I will be giving a seminar at our national family medicine convention (Family Medicine Forum) in Toronto, this November. I put a submission together with my colleague, Dr Stephen McLaren, on "Electronic Medical Records: the first year of computerization". We have invited a Practice Management Consultant from OntarioMD as an additional resource. It should be fun and interesting; we'll really concentrate on the practical aspects of implementation.

I have now just finished my last class of my MSc; I am writing my thesis, much of which is about the transition to EMR. The last course was Thursday mornings, from 9 am to 12 noon; what I have done is left that time slot open for a couple of months. I think I will use the time to put what I have learned --through day to day implementation as well as from my courses-- into practice and give something back to my community: I will go visit some of my colleagues at their office. We have this new Peer to Peer program from Health Infoway, it says that we can offer support on-site; perhaps some of this can fit the PtoP program. I'll see if I can fill my dance card.

My practice partner works at the hospital today. I configured access to the EMR in the doctor's room, on the floor where he works; he told my secretary yesterday that he will be looking at his lab results remotely. He no longer has to call her for results on Fridays. He is now comfortable using our e-messaging system, and is also assigning tasks electronically; he told me that all his INRs are now managed via electronic flow sheets. I printed and gave him my list of medication favourites; he ticked off drugs that he uses often. I entered those in for him, which will give him a head start on prescribing. We practiced entering medications in the CPP, and did a prescription together.

He is approaching the transition with an open mind, and trying things out. He knows that the EMR is not perfect (not even close), but he is also aware of the significant advantages it has over paper records. I think that this is a very sound and very realistic attitude to take. He does have more support than most of my colleagues who are adopting EMRs; I hope that over time, what I am describing will be the norm rather than the exception.

We continue to have issues with medications. For example, a new study showed that one of the cholesterol medications we use (Ezetrol, or ezetimibe) may not be effective: it lowers cholesterol, but may not prevent heart disease. The study may or may not apply to my patients: a search of my EMR today shows me that two patients are taking the drug. I have asked our FHT clinical pharmacist to review the information, and to log in and see if it applies to my patients. She will also prepare a summary for me. I will review that, and draft a letter. Her summary will also be forwarded to my FHN colleagues; thanks to our experience with preventive services, we are familiar with the process of mailing information to patients as a FHN, and not just individually. We will then decide whether such a mailing is needed. We can accomplish far more as a group than individually.


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