Friday, February 09, 2007

The non-EMR physician in a wired office

My practice partner seems to be happier. There was a lot of disruption during the EMR implementation, almost none of which benefited him personally. I think he tolerated this because he knew it was important to me. I was pretty careful with the financial aspect; I showed him everything, we agreed on the extra amount that I would put in for common computer expenses (such as networking), and if I had a bill that was clearly EMR related, I paid for it myself. The disruption is now over, and the office is running smoothly again (although with a split personality).

He still does not want to go EMR. He does not type fast, and is not all that comfortable with computing. Even with an office that is now fully configured for EMR, he just can't see making that step; I think the change is just too big. It is sometimes difficult for him to see my patients when I'm away, because he can't easily navigate an electronic chart. My staff helps, by printing CPPs for him. He knows where CPPs are, and knows how to look at encounters. I try to help by managing my lab and reports remotely when possible.

The resident in my practice spends half her time with him, and half with me, so that some of her patients are on paper, and some on EMR. We put alerts in the demographics so that the secretary knows whether to pull a paper chart for her. It is creaky, but it works for now.

I wonder what will happen as more parts of the system and more physicians go electronic. There may be a time when labs no longer issue paper reports, perhaps as a cost saving measure. At a family medicine meeting yesterday, almost half of the physicians put up their hands when asked if they were looking to computerize soon. My hospital will be going to Computerized Physician Order Entry this year. Their PACS Diagnostic Imaging system is working well--it is probably not a very big step to integrate the report with the EMR. Plans to link our community-based EMR with the hospital system are proceeding apace. I think we're just about to move past the early adopter phase.

It really is a different way of working. Here I am, writing this from home, with my email and my practice both loaded up on my computer. A specialist just called me a few minutes ago to discuss a difficult case; I had all the data in front of me--and I'm getting used to practicing this way.

And, of course, those of us who have successfully transitioned become IT enthusiasts. I wonder if my partner is becoming tired of hearing about EMR this and EMR that; living with a true believer is not a peaceful thing.


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