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EMR : Adapting Work Flow at the Practice
September 30, 2009, 4:07 pm | visits: 76 | wordcount: 509
By Peter Polack

Recently, when discussing electronic medical records with a colleague at dinner, I was asked to speak about the details of customizing different electronic medical records systems to increase overall work performance at a medical practice. Some of the systems that are available today highlight features such as ease of use, or perhaps the fact that the use of templates is not required. This more modular approach to electronic medical records system features could be sufficient for use within some special medical practices, but overall this solution is one which seeks simplicity at the expense of ability. Sure, it would be great to have patient records in an electronic format, but this doesn't necessarily mean it may not be any easier to derive valuable meaning from the information, or use it practically on a day to day basis - this scenario decreases the overall value of the system in terms of benefits to the practice. The field of ophthalmology requires a robust electronic medical records system - one that is able to document both SOAP notes and high resolution drawings and images. Several years ago we talked with an IT firm which was busy developing an ophthalmology electronic medical records system; we ended up working with them in developing a beta test site, thinking that if the medical records system would work in the field of ophthalmology, surely it could also function well within other medical specialties. Unfortunately, the system was not quite ready for prime time at that time, and as a result we became immersed in a growing amount of basic programming work, without much of a tangible benefit to the practice. Unfortunately, at that time our previous EPM vendor didn't have another product available for us to use, as we were seeking something which was appropriate for the field of ophthalmology. This was the unfortunate truth of the situation, even though the software company was a strong competitor in the overall market. When customizing, an important consequence to consider is the need to apply more time and effort to make modifications to the system. Many systems are ready for basic set-up straight out of the box. However, the true potential of these systems resides in their ability to modify overall operations to the individual needs of the physicians and practice. To move the basic electronic medical records system into an enhanced work flow tool at the practice, some modifications to the systems are necessary. The best way to do this, we have found, is through the collaborative use of mind-mapping software. Mind-mapping software allows members of a group to 'think out loud' in the visual sense. Participants can actually see the work flow diagram, from the entering of patient info, to the selection of an open examination room, to billing and check out. By examining the overall flow of the examination process, we have been able to modify the electronic medical records to better fulfill our needs. This process has helped up find places where work flow can be improved, streamlining the process and creating a more efficient system at the practice.

Peter J. Polack, M.D., F.A.C.S., is founder of emedikon, a medical practice management consulting firm and president of Protodrone, a software development company specializing in medical practice applications. He is managing partner of Ocala Eye, a large multi-specialty ophthalmology practice. See Medical Practice Trends for more info.
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