Wednesday, March 29, 2006

Getting faster

We had our second (and final) training session this morning. We learned how to generate different kinds of letters, and to build our own templates.

I've already been doing letters in the EMR; I've done several referral letters, and now I'm comfortable doing this. I've set up templates for administrative forms that I commonly have to do, such as notes for massage therapy or orthotics. The form is printed at the front, where my patient picks it up and pays for it. This works very well.

My prescriptions are getting much faster; my "favourite drugs" list is getting built up, so prescribing is becoming easier. I have not used my prescription pad since Monday afternoon. I've only gotten one phone call from a very puzzled pharmacist, asking me what "30 doses" of Tylenol #3 were. I have to excuse myself for now, and go out of the room to write prescriptions, so I'm looking forward to having the computer in the exam room with me.

My wireless network is still not up and running, and I have been told that it will be installed next Friday. I don't want to write any more notes in the paper chart; I am jotting a couple of things on paper while in the room, and then write the encounter on the computer afterwards. Putting the clinical encounter in the EMR is now taking me about the same amount of time as writing it on paper, and the notes are much more complete and legible; I am using templates for repetitive things like Upper Respiratory Infections. Today, all my clinical notes were written in the EMR.

I have been putting 2 or 3 Cumulative Patient Profiles per day in the EMR. This is still a time-consuming process, because it has to be very thourough and accurate. Maybe I'll pick one day to do a bunch to speed things up. Once I've transferred a CPP, I write "EMR" on the paper copy, so I know it is done.

My staff will be entering height and weight in the electronic chart; BMIs are automatically generated once you do that, and I will be able to make graphs in the future. I was thinking of buying one of those electronic ear thermometers, so that my staff can check and enter temperatures before I see the patient. Maybe I should buy an electronic blood pressure cuff, so that can be done and entered ahead of time as well; or perhaps I shouldn't--it might be good to leave some work for me!

I should probably do a template for chart forms that I use very often, such as the Preventive Health tables. I can see that I fill out most of the tables at the initial full check-up, and then only go over parts of it at the following preventive exams. I seem to be asking about dental care (flossing), mood, diet and exercise (amongst other things) every year, but I don't need to ask about seat-belts repeatedly. I'll make one big template for the first check up, and then a smaller one for on-going preventive maintenance.

My scanner hasn't been installed yet. Once that is done, we'll start scanning (and shredding, if I see that it works well). I've notified the labs, so I should start getting electronic lab results in about two weeks.

It's a start.


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