Case Studies
Maple Ridge: Four Practices on Five DVDs
Physicians access and document patient information with a few keystrokes
July 2009
Dr. Ken Burns, a family physician and one of PITO’s Local Physician Champions, had been using an electronic medical record (EMR) for four years when, along with several other physicians, he opened a new clinic in Maple Ridge in May 2009. The clinic employs six GPs and seven medical office assistants, and has 12 identical examination rooms and one procedure room.
Why an EMR?
Dr. Burns’ reason for using an EMR in the new clinic was twofold: his own interest in improving practice efficiency and plans for retirement in the near future.
“I am thinking about retirement. Turning my practice over to somebody else will go smoothly if there are no paper records by the time I retire,” he said.
“I used to take reports home at night. I switched to an EMR when I decided I didn’t want to have work left over,” Dr. Burns said.
Using an EMR has also improved his work with the medical students who come to the clinic every summer. “They use computers like pencils,” Dr. Burns said.
Working with an EMR
Before seeing patients, the physicians at the Maple Ridge clinic review the electronic records. During consultations, they limit the use of computers and thus they can give full attention to their patients.
The EMR is also used to book appointments and the schedule is colour-coded. Prescriptions are generated by the EMR and then they are printed and given out to the patients.
Every examination room has a computer and there are computer workstations for the front -office staff as well.
Since they implemented the electronic system, the physicians have about four bags of old charts shredded every month, Dr. Burns said. Currently, they already have four practices on five DVDs and in the months to come there will be no more huge files that you have to leaf through to find clinical information.
Everything will be organized and legible and it will facilitate communications with patients
- Scheduling appointments
- Generating and recording prescriptions
- Generating referral letters
- Downloading of lab results
- Completing forms
- Scanning and storing documents
- Generating and maintaining patient summaries
- Electronic receipt of patient information from other facilities
- Ordering diagnostic tests
- Billing
EMR Features in Use
Using Speech Recognition Software with an EMR
All the physicians at the clinic can use the speech recognition software with their EMR.
- Speech recognition converts speech to text, like a transcriptionist
- You can use speech recognition software with your EMR to complete progress/assessment notes or consultation letters
- You can also use the software to navigate through the EMR and enter data in specific data fields
- You must “train” the software to work effectively with your voice
According to Dr. Burns, some of the main advantages of using the speech recognition software are:
- Interacting with the patients a lot more
- Maintaining eye contact with the patient
- Saves the staff considerable time that it is now used for other tasks because they don’t have to transcribe the physicians’ clinical notes into the EMR
- Helps the physicians who are not good at typing
- Greater efficiency and reduced liability
“In the case of motor vehicle accidents, there is a high probability of having to draft legal reports. The software helps me get an accurate history from the patient and avoid mistakes that can result from transcribing the information at a later date,” Dr. Burns said.
Moving Forward
In the future, Dr. Burns plans to look into more extensive use of the EMR features, such as chronic disease management tools, and is forming a Community of Practice in the area.
Key Lessons and Advice
Dr. Burns on the decision to convert to an EMR:
After 30 years of practice, charts get too thick and patients’ profiles are too difficult to manage. Turning the practice to someone else is challenging unless you have the information available in an electronic format.
Dr. Burns on peer mentorship:
Working with other physicians helps to make the transition from paper to electronic go smoothly.
“Look to see if there are other physicians who have integrated an EMR into the practice at the local level. They will demonstrate the system for you and you will learn from their mistakes.”