The time has come for me to sign off. As you can see in the title, "I will be implementing an Electronic Medical Record in my practice, starting in March 2006. This blog is a diary of what happened".
The EMR has now been implemented; my practice has been redesigned to meet goals for patient access (wait times for appointments are now routinely same day or next available clinic day; time sitting in the waiting room is <1/2 hour, we use email with patients), quality (routine measurement and monitoring, regular team meetings), and efficiency. We work as an interdisciplinary team now; these are not just "buzz words", we actually are doing it.
All of us in this primary care team have traveled far along the road to better care for our patients in the past four years, and the EMR has been a key part of this redesign. We will not stop, but I do feel that a large part of the work has now been done. The key issue remaining is that those of us using EMRs continue to function as electronic islands in a sea of paper and systemic inefficiency. We cannot change this from our practices; such a change will take leadership and vision from the people managing our health care system.
As for me, I am finishing my Masters of Science; my thesis "Effect of EMR implementation on preventive services" will be completed this year, and I intend to publish it. I will continue to work three days a week at my office and two days a week on research projects; I think EMRs and quality of care are an important subject, and that is what my research will focus on.
Thank you for bearing with me as I navigated the twists and turns of an EMR implementation in this small community based family practice. It has certainly been challenging at times, but the outcome is more than worth it.