Mind to Market

Tuesday, January 23, 2007

EMRs in Private Practice

I went in for my annual physical exam last week at my local doctor's office. Although I knew they were implementing an Electronic Medical Records (EMR) system there, I wasn't expecting too much, it is a relatively small practice and most EMRs are beyond their price range. As usual, I was given the obligatory paper sheets on which I attempted to record my medical history as well as that of the rest of my family. Fortunately, I don't have to remember too much although I couldn't tell you when was the last time I got certain shots.

I noticed that the nurses were carrying notebook computers around with them, not exactly handhelds but they appeared comfortable enough to carry. The whole office was apparently on a wireless network pulling up patient records from a central server and editing them on the notebooks. The paper form I had filled out earlier had been entered into the electronic record and the interviewing nurse simply ran down the list on the notebook and filled in other information using a scribe on the touch screen. What was even more impressive was the lab tests that were done earlier in the week by Quest Diagnostics had been integrated into the record and were available right there on my chart.

This practice is part of Integrated Physician Network (iPN) Avista; a Regional Health Information Organization (RHIO) including Avista Adventist Hospital and 14-private physician practices in the Boulder, Colorado region. The network uses an EMR from NextGen Healthcare Information Systems. The software will integrate with the hospital information system from Meditech Inc. The network has also completed a laboratory interface with Quest Diagnostics Inc.

Not only could my doctor order prescriptions directly to local pharmacies, he could also order lab tests and schedule consults with other practices, even those not on the iPN network (albeit using the lowly faxing capability). In the end the reduction in the amount of support services by switching to electronic records will be tremendous not to mention the reduction in number and cost of errors. This didn't come cheap however; the U.S. Health Resources and Service Administration has contributed $2.3 million over the next three years and the physicians and hospitals have put in another $1.5 million.

Those of us who are technically inclined may have a hard time getting excited about less than cutting-edge technologies such as wireless networks, and integrated systems, but for healthcare, and especially small practice healthcare, this is no less than earth shattering.

My doctor did point out a slight flaw in the system; back when they were still paper based the screening nurse would place a red card in the paper tray outside of the examination room indicated that she was finished and that the doctor could continue the exam. Now that they were paperless, the trays had been taken down and the doctors could no longer tell which patients were ready to be examined. EMRs have brought the practice of medicine a long ways, but some low tech information systems may still be superior.

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