Wading into EMR: Going electronic, one step at a time

You don’t have to put your practice through an
extreme tech makeover. Experts offer some suggestions for testing the waters with incremental changes.

By Tyler Chin, AMNews staff. Nov. 13, 2006.


Four years ago, Partners in Internal Medicine considered
buying an electronic medical records system. The eight-doctor practice
was having trouble finding paper charts and had run out of storage

But its doctors weren’t ready to adopt the technology, much less
swallow the $250,000 they were told an EMR would cost. So the group
opted for a document imaging system, not only to address the immediate
problems, but also to position itself for an eventual EMR. It was a
fraction of the price.

“We called it a phase-one approach to achieving some operational
efficiency, and reducing some of our overhead and expenses by
transitioning to an electronic health record in this manner,” said
Debra Roberts, administrator of the Ann Arbor, Mich., group practice.
“What is even nicer was that I didn’t have to change my doctors’
behavior. The only adjustment my doctors had to make was that they had
to get used to looking at the record on the computer versus having a
paper chart, but they still take notes on what we call a physician
check list and they still dictate.”

Given that EMRs have a reputation for being costly and disruptive to
work flow, many doctors are avoiding them. But clinical automation
doesn’t have to be all or nothing, observers say.

Doctors can take baby steps — with document imaging, electronic
prescribing, portable electronic drug references and clinical messaging
systems — and gradually work toward an EMR, observers say. These
stand-alone systems are cheaper and easier to use, and they help both
doctors and staff prepare for an EMR. In some cases, the components can
be linked together and integrated with an EMR, consultants said.

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