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| ASSEMBLY EDITION • ORLANDO, FLA |
You know you probably have to do it eventually - change your medical records system from paper to digital. But it's hard to let go of the familiar ways of doing things to enter the world of computers.
"Going to a digital world is a major change," acknowledged John Bachman, M.D., professor of primary care at the Mayo Clinic in Rochester, Minn., in yesterday's lecture on medical informatics.
However, the incentives for making that change are compelling: greater efficiency, increased revenues and more time to take care of patients. "We spend less than half our time in patient care in a paper world," Bachman said.
Here's a sobering thought: "The U.S. government and other insurance carriers will require digital medical records by 2008," he noted.
Paper systems are inherently inefficient, Bachman said. There are problems with handwriting legibility and completeness of information. Auditing paper charts for illnesses like diabetes is slow - about three charts an hour, he said. Studies show that paper charts are absent or incomplete at about 30 percent of patient visits. "Some people's sole job is to find paper records," Bachman added.
And it's costly to create, store, move and maintain paper records, he said.
Surveys of early adopters of digital records have shown that clinicians have been able to decrease overhead, increase revenues, and improve quality of care for chronic diseases such as diabetes, hypertension and asthma after they switched to digital records, he said. Clinicians who go digital spend less time in administrative tasks and more time in revenue-producing patient care.
Practicing in a new digital world requires a paradigm shift, and not everyone will be happy with the change, he said. Physicians will need to acquire computer skills if they don't already have them. "Your productivity depends on how well you use the computer," he said.
Bachman recommended that family physicians get started with the transition from paper to electronic medical records by gathering information on electronic medical records from Internet sites, such AAFP's Web site and the California Health Foundation's site.
Then go to educational meetings where you can learn how to use the software, he said. Visit other medical practices where you can see EMRs in action. Sit down and list the pros and cons of going digital. And make sure everyone in your practice buys into the idea.
"The number-one recommendation I can make is to involve everyone in the change," he said. "Eliminate the word they and substitute the word we."
He also recommended physicians buy software that allows patients to answer questions on a computer monitor and create their own medical history that the physician can then review and make a part of the patient record.
FP Report is
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Copyright © 2003 by American Academy of Family Physicians.