Electronic medical record agony

Patients: please take your medications!
March 26, 2012
My time on the sex show
May 21, 2012
Hope you guys are all doing well.  I am great as always!

Thought I would post a quick note after struggling all day to enter data.  We use an electronic medical record in the office to record our notes and patient information.  I read in the newspaper all the time how important these are to better medical care.
I would like you all to understand these symptoms are not the panacea they are made out to be.  Our system, Med Access, is very cumbersome to use.  It has a lot of ability to store data in a searchable manner.  It is potentially a very powerful database program.  However getting anything done in the program requires multiple clicks and looking at multiple windows.  It is very slow when you have a patient talking in front of you.  It is awkward and unpleasant to use.  I am trying to make myself use its more advanced features, but this is slow going.  It is actually faster for me to just dictate, not use the electronic data features, and do prescriptions the old way by hand.  How long I keep trying this for, we will see.
In fairness it is beginning to improve with successive versions, and I do think the company tries to incorporate feedback.  There are some advantages in terms of having your data in a searchable format and having warning systems for drug allergies and interactions.  Other systems are not much better.  Perhaps some inconvenience is worth it to ensure prescriptions are legible and your data are easily accessible.  But so far, for my colleagues and I, it has been a major pain.
I wanted to mention this to stick up for my physician colleagues who have not yet implemented electronic medical records.  In the news they are portrayed as out of touch dinosaurs that are too cheap to invest in new technology.  I am young and very computer savvy yet I find these systems a major pain and inconvenience.  They are certainly not more efficient than paper, at best I think they are equal, and really, I think I would be faster the old way.  Did you know there are several different systems in BC?  All are from small companies and all have similar limitations.  None of them interact with each other, so we are reduced to sending letters by fax to each other just like before.
In conclusion while I think these will gradually get better, using an electronic record system in 2012 I do not think is an automatic, easy decision, nor will it improve physician productivity.  I think these systems have a ways to go before they should be widely adopted.
What do you think?  Does your doctor use an electronic record system?  Have you noticed anything good or bad from this change?  Do you find your doctor is now too distracted by typing?  I am interested in your opinions, as always.
Until next time,
Dr. John Vyselaar

3 Comments

  1. Andrea says:

    Actually, I'm a big fan of Med Access. It works very well for the GP office where I was for several years. It was an easy way to keep track of massive amounts of data on each patient (labs, investigations, consult reports, etc.) which I could see might not be quite as big an advantage for specialists who have relatively much less info for larger numbers of patients. It just might not be worth the amount of time it takes to input patient profiles if you're not the patient's primary physician.

    It's important that everyone in the office be adept at using the EMR, as I've been to some offices where EMR was pretty well just used for scheduling the old-fashioned paper system was still used. Obviously, that would make things very redundant and negate any advantage provided by the EMR.

    I'm a good typer and don't need to look at my keyboard so it made things very efficient for me (as I would type as the patient spoke, not making them pause (as I might if I were writing by hand) and not needing to dictate things afterwards, which of course would add at least a couple of extra minutes to each patient visit.

    I really like Med Access, as long as it's being used properly. I've found it's made me super-efficient, but it's definitely caused more problems than they're worth in other offices I've seen. It just depends on how good the entire office is with computers/typing, as well as choosing an EMR appropriate to your type of practice. I've also used Purkinje, Wolf, and a couple of others whose names escape me, and none of those worked for me.

  2. Thanks Andrea for your perspective. Good to hear. I could see the advantage for family doctors responsible for supervising multiple problems. I think it is designed for GPs first and foremost. My two partners went and chose it before I arrived to take advantage of government incentives which did not apply to other EMRs.

    I have been able to type in the meds, allergies and past history, as well as a symptomatic review for returning patients. However I find I have to dictate the HPI, exam and plan afterwards. I know that the plan is the part GPs really care about most of the time, and I am judged on the quality, so I am a stickler to do a good job on this.

  3. Anonymous says:

    Hi Dr. Vyselaar – just wanted to comment on the electronic data recording in most medical offices these days. So often my mother who is a very bright 89, tells me that her family physician neither seems to listen to her nor looks at her as he is so busy typing data!! I've had the same experience with my family physician in the past and often felt that the physician should go back to pen and paper!! Or at least look up occasionally!!
    The first cardiologist I ever saw had read my file before I came to his office. At his office he proceeded to sit beside me on a comfortable bench and said "I've read all about you; now you tell me what is happening!" I have never forgotten him and his lesson in listening to his patient!! And I'm happy to say that my experience with you has been the same!!

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