Case Studies
Bridging the Physician Generation Gap with EMR
Dr Bin Lim has been a GP in downtown Vancouver for 32 years, and recently received a long service award for his work in the ER at St Paul's Hospital. He spends half his time working in the ER and the rest in a family practice that includes obstetrics. He says: "Emergency made me a better GP and general practice made me a better EP." He loves the weather in Vancouver, and the many opportunities to spend time outdoors.
Advice to Colleagues
"Implementing EMR is highly recommended to all colleagues. In retrospect, I should have done it sooner! Even though I am in my waning years, it is still worth it."
"The Twilight Years of my Career"
Although he was aware of EMR from the beginning, Dr Lim felt there was no impetus to make the change in "the twilight years of my career". However: "My young partner Dr Lee joined me in February 2009 and one of the conditions of his joining the practice was to introduce EMR within a year. I'm glad we did it. My secretaries like it too."
New Generation
Dr Lim's new colleague Dr Lee grew up using computers, and many of his peers from university now use web-based EMRs, so this was a natural step for him. He says that Dr Lim implemented the EMR for his benefit, because he is just starting his career and it makes sense for him to be paperless from the start. Although the EMR has not eliminated paper from the office, Dr Lee will not accumulate the piles of thick paper charts that line Dr Lim's office.
Transition from Paper to Paperless
According to Dr Lim, moving to EMR was quite seamless except for one hiccup when switching from previous billing software. He says his poor typing skills have presented a challenge, but he "just kept practising". He says: "The biggest hassle is the transfer of paper charts to EMR. We have chosen to integrate slowly rather than scan all the charts, which would have been too expensive."
EMR as a Tool
Implementing EMR probably won't save them money because they're a small practice with a low volume of patient visits. As for patient care, as Dr Lee says, "EMR doesn't automatically, or by itself, make you a better doctor. Its usefulness depends on the physician and how they use it." He emphasizes that the EMR can enable good record-keeping, but it won't do it all for you – it's a tool, not a panacea. "However, it does have the potential to catch things you may miss, and remind you of things that you have missed," he says.
For example, many of the practice's patients have been prescribed narcotics. The EMR allows Drs Lim and Lee to easily see when a patient's last prescription was issued, and what it was. Of course, this would be carefully recorded with or without an EMR, and a triplicate paper copy is still required; but the computerized system makes it easier to pull up the information. In the same way, they have easier access to notes from physicals; and can generate graphs to illustrate trends.
Covering for Vacations Easier with Legible Records
When Dr Lee asks him every now and then whether he finds things faster with EMR, Dr Lim says he's getting there. He's not actually working faster yet; but he can keep a better, clearer record of what's been done, where and when. It's a great help when covering for each other. With EMR, there's no need to hunt through piles of charts; and there are no problems with illegible handwriting.
Ease, Organization, Communication
"My partner and I love the system," says Dr Lim. "I love the ease and the organization; the good communication with my MOA; and the great scheduling system. Patients love it as they can read my prescriptions and notes. They don't even mind that I type periodically. The EMR is web-based so I can be away from the office and, if I want to catch up, I can still do my charts. It's not recommended for a workaholic!"
"I love the ease and the organization; the good communication with my MOA; and the great scheduling system."