Nancy M. Silva, MD, FAAP
Our office went “live” with Electronic Medical Records (EMR)
in March of this year. This was and
still is a difficult change to master.
EMR is supposed to streamline the work process, improve healthcare, and
improve communication with our patients.
But does it really?
In the beginning, it felt as if all communication between
everyone within the office and with our patients had been altered and damaged
forever. So, no, initially, EMR didn’t help
or improve anything. Frankly, it hurt a
lot.
First, everyone in the entire office needed to learn the new
system. This made wait times unbearably
long. Why? Think of every step that an office visit
entails. There’s the phone call to make
an appointment. The front desk staff has
to learn a new way of doing that. There
is new paperwork for a patient to fill out.
There’s a new registration process, which now includes capturing a
photo. There is the nurse’s and the doctor’s
assessment. There may also be office lab
tests. Lastly, and most importantly,
were all the apologies given to the patient that included explaining the new
process and why EMR would eventually be better for everyone. The growing pains were excruciating. Throughout the process, we learned that
constant communication with our patients and their families was crucial.
It has been difficult to communicate in the exam room with a
computer in the room. It is literally a
physical barrier. Neither the patients
nor I liked it. That is until I figured
out how to still be human with a computer in the room. Mostly, I divide myself in two. I explain that first we’re going to get
through all the “virtual paperwork.”
Then, I’ll be hands on and have time for questions. That divide is necessary in order to meet the
EMR requirements while still being a caring doctor. Since creating the division, the parents seem
happier. They know the course of the
visit. They know what to expect. And they know their doctor is not just going
to be looking at the computer screen the entire time. There is still time for humanity;
communication up front is the key.
On the flip side, there is an aspect of EMR that the
patients and I do enjoy. Improved
communication!
So, what has improved with regards to communication? Parents have more options. Now patients can call or email
questions. Parents receive more
information, more quickly, and more efficiently with less errors. The pharmacy can email prescription refill
requests directly to the doctor. Laboratory
results are received more quickly.
Hence, I can give parents their results more quickly as well. Any day parents receive an answer more
quickly regarding their child’s health is a great day. Responses to phone calls are also
quicker. In addition, they are now more
accurate. Now, there is no misunderstanding
as to what advice I gave the nurse to discuss with the parents. Everything is written in the EMR. Messages aren’t getting forgotten or lost, as
there is an electronic trail. In
addition, we can look back at every piece of advice ever given. This is helpful with a prolonged or
complicated illness. I also enjoy
showing parents their child’s growth charts on the screen. The parents seem to understand the visual much
better. Lastly, at the end of the visit, most parents receive an educational
handout, either specific to that well child age and visit or to their child’s
current illness. Parents are happy to
review what you just discussed, as opposed to relying solely on their memory.
So, three months later, I would say, the answer is yes. The work process has become more efficient,
healthcare has improved, and communication has eventually improved as
well. Mind you, there are still growing
pains. Updates in the electronic world
are frequent. Adjustments occur daily
and are both inevitable and necessary.
Everything seems to have changed with the introduction of
the EMR. However, communication is still
paramount. I still maintain a personal
human touch, just with more options on how to do so.
