The new requirement for all physicians to use electronic medical records has challenged today’s Family Physicians, who already rely heavily on electronic data. This guide is intended to help you navigate this increasing complex area without losing site of your priority – patient care. From patient monitors and new patient surveys of medical history, to the sophisticated imaging and records systems your consultants use, the accuracy and reliability of these data systems are paramount for delivering safe, high quality primary care. Failure of your Electronic Medical Records (EMR) system is not an option, nor can you allow files to be lost or consultant records to be incompatible with the EMR you choose for your busy practice.

FAMILY MEDICINE-SPECIFIC EMR’S

The EMR System you choose needs to be able to integrate into your office setting. For example, if you do physical exams, EKG’s, and x-rays all in different rooms, you need your EMR to let you view updates to the patient record immediately, from any computer. Improved efficiency for your daily operations will help your office run more smoothly and with less interruptions, allowing your to spend more time with your patients and see more of them each day. The ideal EMR for you will depend on your specific office’s workflow, the equipment you and your consultants use, and the types of procedures and capabilities you plan to add to your practice as you grow. Therefore, we will begin here with the assumption that to allow for your next level of efficiency and capabilities, your ideal EMR will let you view all patient records from one user interface, not multiple software programs for different types of records.

VERIFY EQUIPMENT AND SOFTWARE COMPATIBILITY

When you send your patients to a consultant, you frequently don’t get the benefit of viewing their ultrasounds, CT scans, or electrophysiological data to help you best interpret the test for your specific patient. As the patient’s primary physician, only you take the time to understand all of their circumstances and an EMR System that can let you see all the data that the specialists see will better equip you to do just that. The trouble is that, for example, many imaging centers and radiologists use different machines and software, so even if they send you a CD-ROM your computer can’t read it. This prolific problem is getting dramatically worse over time, as more and more technologies hit the market and you can’t predict which direction your consultants will choose. For example, if your favorite cardiologist uses iCardia Holter Monitors you may have no way of seeing the EKG tracings of your patient’s arrhythmias for yourself. If you figure out how to see the EKG tracings and then the cardiologist switches brands to Braemer you have to start all over again. Solving the endless technology challenges is not, we suspect, why you went to medical school.

EASILY TRACK STAFF AND PATIENTS’ ACTIVITIES

The last thing your EMR System should be is a burden to those that use it the most – your office personnel. Verify that your EMR will integrate automatic patient appointment reminders, preventive health maintenance protocols and other scheduling details unique to your practice. Mammograms, Pap smears, follow-up stress tests, and immunizations are a few issues that your new EMR System can address. This will ensure that no tests are forgotten and no one slips through the cracks on your busiest day, thereby improving compliance.

Special tests such as fasting oral glucose challenges often require that your staff spend time sending out reminders and tracking down results prior to their appointment with you. An EMR System that could integrate automatic emails or phone calls one week prior to an appointment would improve efficiency. Suffice is to say that many repetitive tasks can be integrated into an office system that curbs human error and improves your practice’s measurable outcomes.

DOCTORS OFFICE QUALITY – INFORMATION TECHNOLOGY (DOQ-IT)

The Centers for Medicare and Medicaid Services created the DOQ-IT program to encourage of adoption of EMRs and focuses on improved patient outcomes for small and medium-sized physician practices. Choosing an EMR that is compliant with DOQ-IT will provide effective billing practices, optimum pay-for-performance reporting, and improved patient outcomes.

DICOM COMPATIBILITY

Digital Imaging and Communications in Medicine (DICOM) is a standard construct used increasingly by Health Information Systems, but it is not universal. Specifically, DICOM covers handling, storing, printing, and transmitting information in medical imaging. A popular imaging viewer is the PACS system, but it does not have the best interface for some media such as video loops of Doppler ultrasounds. You will want to make sure that the EMR you choose will allow you to view imaging from your own office and that from your consultants.

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