Case Studies
Working in Multiple Locations is Easier with EMR
Dr Richard Welsh is a GP in a group practice in Abbotsford. He's been in practice since 1989 and first implemented an EMR with his colleagues in June 2006.
Dr Welsh has a proven interest in improving primary care delivery: he was part of Fraser Health's Primary Care Reform Physician Steering Committee, and has a consulting business called AccelEMR Solutions that helps physicians optimize their EMR and workflow systems. He enjoys Abbotsford's sense of community and the opportunity to be involved in hospital work.
Advice to Colleagues
"EMR is not the solution on its own. EMR is a huge enabler, but you have to put time and energy in to setting up the system and delegating tasks. It's all in the detail."
"When you get things set up properly it makes things more fun, and when you're having fun you provide better care."
Using Better Tracking, Prompt and Recall Systems
Dr Welsh feels strongly that, when properly set up, EMR can vastly improve longitudinal patient care and outcomes by using better tracking, prompt and recall systems and providing ready access to a wide variety of reference tools available at the point of care. "In addition, EMR saves a significant amount of MOA and physician time which can then be used to see additional patients," he says.
One EMR feature is the reliable alert system, which has taken a lot of work off of his plate. "We can set alerts to pop up at different times for different people. For instance, when a patient is due for fecal occult blood screening, an alert pops up for the MOA when the patient arrives, prompting the MOA to give the patient a test kit," he says. There's a drop-off box in the waiting room; the doctor doesn't have to do anything. Previously, he ran the risk of running out of time during the appointment, and forgetting to mention the test to the patient.
"The tools and workflow changes we have developed save us at least $18,000 per doctor per year in MOA and physician time."
Optimizing Scanned Document Workflow and Usefulness
Dr Welsh can delegate a lot of other tasks to his MOAs. A huge timesaver for him is having an MOA mark up all incoming scanned documents using Adobe Pro. "Before I ever see the document, the MOA has underlined relevant information, added procedures and significant investigations to the patient's problem list, added an 'Action' stamp if I need to do something, and entered a recall into the system if the patient needs something done in the future (such as a colonoscopy every two years). At a quick glance I can see what she's done – the MOAs actually do a much better job of this than doctors because they can afford to spend more time doing it," he says.
Simplifying Tasks
The EMR simplifies many time-consuming tasks:
- Staff can email Pap reminders
- Doctors can provide tailored lists of patient education resources during the patient visit
- If there's a warning on a drug, staff can quickly find all the patients using that drug and ask them to come in for an appointment.
"Email communication is becoming very useful clinically, and very convenient. The EMR can generate an email list; for instance in the fall we emailed all our patients about flu clinic times and eligibility," said Dr Welsh.
Dr Welsh also appreciates the tools embedded in the EMR, such as auto-populating forms for chronic disease management, investigations and referrals; and evaluation and monitoring tools for conditions like asthma or mental and cognitive problems.
Optimizing our EMR workflow, systems and tools allows us to deliver better longitudinal care, reduce overhead and have more fun in the process.