Edward Bujold, MD

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Among large physician practices and acute care facilities, physicians and healthcare executives widely recognize the value of electronic medical records (EMRs). However, physicians at small or individual practices are just beginning to use the technology, noting high implementation costs as a deterrent.  

At the Family Medical Care Center in Granite Falls, N.C., we have been using an EMR by Misys Healthcare Systems for several years. As a result of using an EMR, patients receive improved care since doctors can make better-informed care decisions and can ensure higher degrees of patient safety. Additionally, we've adjusted to the growing trend of consumer-directed healthcare and have started to develop preventive health/disease management programs.  

First, using an EMR meant that all patient information would be available instantaneously. Time and resources are wasted as nurses and assistants search through paper charts, not to mention that despite the best efforts to keep charts organized, critical documentation can easily be misplaced or destroyed. By using an EMR, simple electronic searches retrieved a patient's complete medical record from any office desktop. Before seeing patients, we are able to review information from several visits, symptoms and illnesses they've had before, and medication or treatment we have prescribed. Knowing what has worked or what hasn't worked in the past gives us the ability to provide more effective care now.  

With a patient's complete medical record available, we have the ability to alter treatments based on past or concurrent conditions. The EMR system can pull up any patient information at any point in time. We are able to track the medications a patient has taken, results from tests and condition improvement. This information gives us the ability to determine which treatment options worked best for a patient and we use this information to make care decisions daily.  

Finally, with an EMR, a patient's record moves with him or her across the continuum of care. We rely on a PDA and can pull up patient information at the hospital or specialty clinic. My patients are reassured by my presence outside of the office and by knowing their complete record is available as well. Surgeons, hospital physicians and nurses, and clinical technologists also have access to this information as they care for the patient.  

Several elements of the EMR system are directly tied to improved patient safety. One tangible example is the use of computerized physician order entry (CPOE). Using CPOE through the EMR, we have the ability to track patients' medical prescriptions from order to administration. A comprehensive formulary, which works with the EMR, tags any potential cross medication complications from the list of medications in the patient's record with new medications we prescribe. The result: virtually no cross medication errors and we are able to track the patient's condition improvements.  

One of my patients commented on the sense of security he felt as a result of our system switch. As mentioned above, not only are the records more secure since paper charts can be lost or destroyed, handwritten errors are eliminated.  

The trend of consumerism continues to rise within the healthcare industry and as a result, we've seen patients become more critical of the services they receive. By implementing an EMR system, office workflow has dramatically improved. The best way to support this claim is by patient feedback. 

Several patients have commented on the reduction in office visit time. Nurses and physicians have quick access to patient information, specifically information about previous visits, symptoms and treatments. Patients spend less time filling out paperwork and the physicians can spend more time with each patient rather then sorting through a cumbersome paper chart. Furthermore, it is disconcerting to a patient, who expects optimal attention from their physicians, to have to repeat his or her ailments time and again.  

At first, I expected some backlash from patients expressing that a wired office would feel cold and less personal. The EMR has given me the ability to show more attention to patients.  

Articles

Among large physician practices and acute care facilities, physicians and healthcare executives widely recognize the value of electronic medical records (EMRs). However, physicians at small or individual practices are just beginning to use the technology, noting high implementation costs as a deterrent.

Author | Edward Bujold, MD

Articles

The immeasurable value of EMRs for improved patient care