Case Studies
Flexibility of Practice in Remote Medicine
Prince Rupert: Solo Family Physician Uses an EMR to Work from Multiple Locations
July 2009
Dr. Herman Greeff, a solo family physician, has helped shape the EMR landscape in Prince Rupert. He went live on May 14th 2009 and is the first physician in Northern Health on a PITO-qualified EMR.
Using an EMR for 5 months Number of visits: 800 / month Location: Prince Rupert, B.C. (pop. 15,000)
Why an EMR?
After Dr. Greeff’s original practice closed with the death of the lead physician, the EMR saved the day by allowing him to work from four sites plus hospital shifts to meet local needs.
“I couldn’t do it without an EMR. Physicians who practice from multiple locations need access to information in real time,” Dr. Greeff said.
Working with an EMR
Dr. Greeff is currently in transition from paper to the electronic system. “The transition is going well and I foresee we’ll finish in about six months. The transition has been accomplished with minimal training and disruption,” he said.
The most time-consuming task was creating patient profiles in the EMR while also learning how to use the system, Dr. Greeff added. But once you are finished, the EMR can make you very efficient.
- Generating and recording prescriptions
- Generating referral letters
- Completing forms
- Storing documents
- Generating and maintaining patient summaries
- Electronic storage of patient information from other facilities
- Ordering diagnostic tests
- Billing
EMR Features in Use
EMR Benefits
“I file no lab records anymore although it still takes manual entry for incoming paper-based information. However, due to the EMR, I work twice as fast as before the switch to the electronic system, “ Dr. Greeff said. Paper is too bulky and it creates a lot of work because everything is duplicated, he explained. The EMR helps avoid duplication and it saves a lot of time. “Since switching to an EMR, I am really enjoying my new work / life balance,” he added.
Dr. Greeff now has access from multiple sites: hospital, cancer centre, nursing home, ER, doctors’ lounge and home. His billing clerk works from home 80% of the time.
During consultations, he uses the EMR to call up the patient record, check out clinical notes from previous visits and review medications. Patients are very comfortable with Dr. Greeff’s use of an EMR and they have never questioned the presence of a computer in the examination room, he said.
Challenges
An ongoing challenge is the data-entry requirement for incoming paper-based information. “I still have to print out lab and x-ray results on paper, I am not completely synchronized with the hospital,” Dr. Greeff said.
Moving Forward
Dr. Greeff is planning on getting voice recognition software by the end of this year. “It would help me a lot because I speak faster than I type,” he said.
Dr. Greeff is using the EMR to limited capacity, mostly for booking and billing, but he is hoping to be able to use enhanced EMR features such as downloading lab results into his EMR by the beginning of next year.
He is also looking into forming a Community of Practice in Prince Rupert in which to include family physicians as well as specialists.
Key Lessons and Advice
Dr. Greeff on choosing an EMR
“Find an EMR that can do what you want done (...) Look for security – confidentiality, good interaction with the vendor, dedicated IT support and high standards. It’s a good idea to go electronically especially when you have gone through closure of practice.”
Dr. Greeff on forming a Community of Practice in Northern B.C.
“It would streamline communications, we could work together and help each other out and we would have a better interaction with the specialists.”