Saturday, March 17, 2007


I was away on vacation this week. This is now the third time that I've been away on holidays since starting the EMR. It was also the first time that the week before vacation was manageable; I think the efficiency is really starting to kick in.

I've noticed that the majority of lab results come in by Saturday; I had 12 labs to look at on Saturday, and only a few results came in afterwards. It is good to keep that in mind if planning to log in while away: the bulk of the work is in the first few days. As for previous vacations, I let everyone know if I will be accessing the EMR. What seems to work best is intermittent access: I don't want to be forced to look at results daily while on vacation, but I don't mind having a look every few days. That means that my partner has a quick look at the incoming data, and only takes care of urgent problems (like abnormal INRs).

Here is what I ask my partner to do while I'm away:

  • Cc me on lab reqs so they go in EMR
  • For incoming lab results:
    • If they are normal, put them in the “to shred” box
    • If they are slightly abnormal, put them in the “to shred” box
    • If they need action, please write on them and then ask staff to put them on my desk after the action is taken
  • For incoming letters/faxes, pls put them in the “to scan” box once you’ve seen them
  • CPPs will be printed for you as needed
  • If you need to see scanned old chart, there is a link on your desktop, double click on the file
  • If you need to see a report on the EMR, go to Patient module, reports, then DI/lab etc.
  • Our family medicine resident can see some of my patients while I’m away
Looking at labs/DI/consult notes is much more efficient if you know the patient and the context. Long consult notes can be left unfiled after a quick look, for more extensive review post vacation. Doing this lightens the load for your partners, and may make going away less difficult.

I am still receiving lab results on paper as well as electronically. Once my group decides we're ready to stop the paper, we have to notify the labs; this must be done as a group. For the past several months, I have not been looking at my paper labs, and they go straight into shredding. I'm not sure what I'll do during vacation once the paper labs stop, since my partner won't have those to look at.

I wonder if this would work for some maternity leaves. I know it has sometimes been difficult to get locums for maternity. It may be possible for one locum to look after several practices via remote access; the physician can decide to come in half a day a week after a couple of months, while doing much of the work remotely during baby's nap (if they nap).

My schedule for Monday does not look horrible; I think the week before and after vacation is much easier to manage this way.


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