Electronic Medical Record Survey Results: Medscape Exclusive Readers' Choice

Leslie R. Kane, MACC

Disclosures

October 06, 2009

In This Article

Advice on Choosing an EMR

Choosing an EMR was clearly a time-consuming ordeal for many physicians, and the results were not always satisfactory. To spare other physicians similar mistakes, Medscape asked EMR owners, "What is the most important piece of advice you would give to other physicians who are preparing to purchase an EMR?"

Some physicians advised other physicians to steer clear:

  • "Don't buy one. It is not worth it."

  • "NOT more efficient, and HIPAA rules and such make it an expensive and glorified filing and retrieval system. An EMR slows down the pace at which I can see patients."

  • "Don't. Unless the government can come up with ONE vendor that talks to everybody else's system, it is not worth the investment. Physicians that are all gushy about them are treating sore throats and ankle sprains, not complicated medical problems. Or they're used to the boilerplate answers that the EMR provides. EMRs really depersonalize the patient encounter since you are spending an inordinate amount of time staring at the screen and not the patient."

Other physicians still have some reservations but ultimately believe that EMRs are helpful to medical practices:

  • "You must get an EMR."

  • "Be brave and go for it."

  • "EMR is absolutely the way to go -- even with this rotten system, patient care is vastly improved. But it will take you way more time to document -- don't let anyone tell you otherwise. No one figures this into the cost of the EMR -- certainly not administrators. Save money -- what a laugh. Yes, it's better care, and that's why I'd never want to return to paper, but there is a cost -- a very high cost -- to the clinician in terms of time. It's a high-maintenance operation."

  • "It is going to be difficult, time-consuming, and painful. But if you get the right system you will never want to return to paper charts."

  • "After the first couple of years, it is rarely down more than a 1/2 hr. You can thus find med Rx, lab results, etc for any of your patients and those of your colleagues when on-call via your home computer. It requires a change in mindset. Instead of a succinct note capturing the essence of the visit, there are reams of bland computer text derived from check boxes. Those require much updating as consultants notes, imaging reports, etc. come in, all of which takes oceans of time."

Many physicians gave tips for making the selection and implementation process more efficient:

  • "Make sure the EMR you choose fits your needs. Arrange a trial period such that if it doesn't meet your needs, you can return it. Allow plenty of time to learn it. It can add an hour a day to learn for the first year."

  • "Don't skimp on training costs. Plan to bring trainers back several times to get up to speed on all features."

  • "Visit an office using the system and interview the office manager and MDs."

  • "Research it properly."

  • "Make sure the company has good customer service."

  • "Choose a system that allows you to create your own templates and free-text."

  • "Know what you want it to do, make sure it has connectivity with e-prescribing, and that you can have it work seamlessly with the billing software. Expect glitches, frustration, and even moments when you want them to take it away. Hang in there, and if you researched carefully, understand your practice and yourself well, it will be a big plus. We were using an outside billing company that cost us over $18,000 before, and now we have more clean claims with the data in EMR to back us up, and have recouped our initial outlay in less than 3 years."

  • "Ensure all in group are keen and willing to go through growing pains."

  • "Prepare for light schedules when training."

  • "It is a necessary evil but not easy for those of us who are not computer savvy."

  • "Take a close look at your current office workflow, processes, and charts. Plan, plan, plan. Dedicate resources to the preload process and expect some reduction in productivity. It's all worth it."

  • "Make sure ALL physicians have training."

  • "Allow staff who will actually be using it in on all the options as well as the decision-making process."

  • "Don't try to convert all paper up front. Decide what you really need -- you will find not much at first. Use the conversion opportunity to clean up charts in the sense of updating. Also, chart at the time. If you pull a paper chart more than once, THEN convert it."

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