Case Studies
Langley: Dr. Leo Wong is fascinated by the potential of electronic medical records
July 2009
At some practices where he was a locum, Dr. Leo Wong used a hybrid model, where a combination of paper and electronic systems were being used simultaneously. However, none came close to being totally paperless. "I was disappointed with hybrid EMR-paper based systems," Dr. Wong says. "So much work was duplicated that efficiency actually slowed down."
When it came time to open his own practice, St. Luke Family Practice in Langley in 2003, Dr. Wong and his wife Flora, also a family physician, had specific ideas about how they wanted to run their office, including using electronic medical records exclusively. They worked with an architect to design their paperless office and made provisions for the network wiring, but not for chart storage. By planning ahead and sharing a common vision, Dr. Wong side-stepped the time-consuming transition from paper to electronic records.
Then, in 2007, Dr. Young Suh joined St. Luke Family Practice. On December 31, as Dr. Suh moved into the practice, 12 boxes of charts arrived on St. Luke's office door.
The transition was challenging, partially because no one knew which patients would be continuing to see Dr. Suh and which would continue at the previous office. For the first week, while the boxes cluttered the office, Dr. Suh only entered patient information numbers on billing forms because he couldn't access the paper charts to complete all the required demographic data.
The partners soon realized they couldn't function one more week without tackling the paper charts. For a full weekend, the three of them worked around the clock entering demographics into the EMR system. Then, finally, if a patient's name came up, they knew they had a paper record for them. According to Dr. Wong, "It was the single biggest and best step we made. After three months, we didn't need to pull paper charts and everything really came together."
Over the next 11 months, one medical office assistant (MOA) worked an extra day a week to scan all Dr. Suh's charts. Today the boxes are gone and the practice is again paperless.
To Dr. Wong, the major advantage of an EMR is mobility. "I have incredible flexibility in where I do my work," he says. "I can monitor lab reports from anywhere and, on home visits, I have the patient's chart right in front of me, exactly as it would appear as if I was in my office."
"I have incredible flexibility in where I do my work. I can monitor lab reports from anywhere."
The other advantage is the speed of checking lab reports. "If there is an abnormal result, I can get to the patient's chart with just one further click," he says. "With paper, it potentially took one or two days to get the typed report, then my MOA had to get the chart, then I had to compare past results and finally decide if I had to just file the result or recall the patient. Depending on the patient load for the day, this whole process could take hours of back and forth paper shuffling."
For the staff of St. Luke Family Practice, the greatest benefit is they no longer spend time searching for lost charts or misfiled pieces of paper. Instead, they have additional time doing more clinically relevant work such as running reports to ensure chronic disease patients are up to date with their care.
"Don't think an EMR will eliminate a staff member - it won't," warns Dr. Wong. "Instead, the EMR makes managing the practice more efficient so the staff has more time to help with triage and get to know the patients better."
Dr. Wong is so sold on EMR that he has become a Local Physician Champion through the Physician Information Technology Office, helping other physicians learn about and adopt EMRs.
"At first, transferring from paper to an EMR does involve a lot of work and a lot of planning," he says, "but overall, it really increases practice satisfaction for the physician. I'm proof of that."