EHR Success Stories

Michael Cohen, MD, says, "There is no doubt in my mind that a generation from now practitioners will look back at paper records the way we look back at pneumoencephalograms."

Benefits:

I have been using the EMR system Practice Partner, from PMSI, since 2001. This program includes a billing module, appointment module, and electronic medical records.

Under no circumstances could my staff or I be compelled to switch back to paper charts. I am very comfortable with computers but am in no way a guru, and this system is straightforward to use and build on.

The documentation of medical encounters is template driven; when I sit down to see a patient for the first time, a note with Past, Social, and Family history, and vitals is already present on the workstation. I type the history as I interview the patient and use a templated neurological exam. Other templates enable me to ask all pertinent questions of patients with specific problems, like MS and Parkinson's disease, by going down a checklist. This prevents me from forgetting to ask something, and enables higher level E/M coding criteria to be met.

I have not had to use a transcriptionist for the past five years; I am sure this alone has saved me more than the entire cost of the system.

When a pharmacist, other physician, insurance company, or patient calls with a question about a given patient, procedure, or treatment, there is no need to careen around the office looking for a chart; it can be accessed in seconds. And no physical space is necessary to store the records.

Anything that can be converted to a computer file can be stored on the server and an internal hyperlink can tie it to the chart. So a photograph, a video in a movement disorder case, or a screenshot of an MRI scan or an EEG abnormality (from a digital EEG) can be attached to the appropriate section of a patient's chart, enabling easy comparison to previous visits or studies. When another physician calls to request medical records, it is a snap to convert the entire chart to a pdf file and email or fax it (without any intervening step that entails printing or paper).

Having tabular access to the medications that the patient is taking, has taken in the past, and especially which were unsuccessful, is tremendously useful, as is the drug interaction information built into the system. We have an interface with the lab we use so most results that come into the office are directly entered into the chart (and have to be signed off electronically so nothing is missed).

People often ask me if I am not worried about losing all my data. I turn that around; if their office catches fire and the paper charts all burn up, where is the practice then? Meanwhile I back up to an encrypted external hard drive and take it home with me each evening. If I come back one morning to disaster I could be back in business in an hour!

I subscribe to what amounts to an online neurology text, Medlink. Since it is already in electronic form it is easy to cut and paste information from an entry into a chart or a note to another physician. By using simple "dot-codes," information for the medical records can be exported to populate problem lists, medication charts, or customized lab or flow chart templates. (So my template for an LP has a "dot code" that sends the opening pressure I enter into the note to a flow chart, obviously useful for patients with idiopathic intracranial hypertension.)

The question is not if practices are going to convert to paperless, it is when they are and what features the systems will include.