Electronic Medical Records

This is so 20th century! There is no doubt that electronic as opposed to paper medical records help improve the quality and the efficiency of care given.

We have used electronic medical records here at Schlesinger Pain Centers since the office first opened in January of 2008. The reasons are manifold. The records are more legible, often more complete, hopefully more accurate, more readily available, easier to find, more environmentally friendly and hopefully in the end more economical.

I have always hated going to a hospital or clinic chart to look for some important information only to find that it is illegible. Add to that the fact that I know that my handwriting is not particularly neat even by a doctor’s standard. In the hospital I try to compensate for this by printing, but even that has its problems. Sloppy printing is almost as hard to read as sloppy cursive and it is much slower. The tendency to be laconic and abbreviate degrade the quality of the record, which brings us to the next point.

I am a pretty fast, if not always accurate typist. That combined with the ability to add customized buttons and pick lists to an electronic medical record makes them much faster to create and hopefully more complete. You can also add customized prompts to an electronic medical record to help you and the staff remember to dot all of the i’s and cross all of the t’s. This may sound trivial but repeated studies of medical quality of care indicators point to record keeping and clerical errors more often than errors in judgment.

Electronic medical records also have the potential to be more accurate than handwritten ones. Many EMR systems have the ability to automatically generate lab slips and prescriptions as soon as they are ordered. This eliminates transcription errors and when used with the appropriate drug and laboratory databases cuts down on things like decimal errors.

Nearly universal availability is yet another advantage of electronic medical records. Most systems are either web based or can be accessed remotely via virtual private networks. This means that if I have a question, I can access your records from a hospital, surgery center or even from my home at night and on the weekends. We have literally thousands of patients here a Schlesinger Pain Centers and I do not want to have to rely on my fallible memory to decide what dose of muscle relaxants Mrs. Jones was on or exactly where the lumbar protrusion is on Mr. Smith’s MRI that is causing the chronic pain. With our EMR all I have to do is connect to our VPN and I am sure.

Even I am in the office electronic medical records are easier to find. There is no chance that they will get misfiled. The same record can be viewed simultaneously by any number of people, so I never have to ask who took Joe Black’s chart off my desk. This is also a big advantage when another physician calls up with questions about one of our patients. The ability to bring up the records quickly myself saves his time and my time.

One promise of electronic medical records that we have been relatively slow to realize is a positive effect on the environment. We are currently on our second system because the first one did not offer E-faxing. This meant that every time we wanted to fax a report to another physician we had to print out a paper copy, which would be shredded as soon as it was sent. Our new system supports E-faxing as well as E-prescribing. Most of our charts are never printed, unless the patient requests a copy and even those can be sent as Email attachments.

The last promise of electronic medical records, cost has proven the most elusive, but it was never the deciding factor in implementing the systems in any case. Part of this is due to the high up front cost of setting up the system. The remainder is due to the ongoing costs of data security and system maintenance. We are hopeful that as we continue to grow and spread these cost over more and more patients, electronic medical records will contribute to our efforts to hold down the cost of medical care. For now, it is enough that they contribute to the increased quality.

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