Physicians have heard countless times the benefit that an EMR can have on their practices, but having one can also improve a physician's life away from the practice.
Mention the term electronic medical record to a physician and you’re likely to get a pretty robotic, head-nodding response. That’s because they’ve heard about the benefits of an EMR to their medical practice — reducing health care costs, streamlining workflows and improving patient safety — so many times they can recite them in their sleep.
But what is not often talked about is how an EMR can enhance a physician’s lifestyle. In other words, improve his or her time from the practice.
“I implemented an electronic medical record and it has changed my life,” says Charles Crutchfield, MD, principal of Crutchfield Dermatology in Egan, Minnesota. “If I had to go back to the old system, I wouldn’t do it. I’d find another profession.”
When Crutchfield started his practice in January 2002, he decided it was the right time to implement an EMR.
“I thought, ‘It’s the wave of the future,’” he remembers thinking. “‘I’d better do it now or else I’ll never do it.’”
He did it, and he never looked back. And the benefits, Crutchfield explains, have been significant.
“It’s much more convenient pulling up records,” he says. “I have all my records in patient photos. As a dermatologist, I’m really visual. I can see a patient’s picture and remember the entire encounter. I can access my records from anywhere in the world. That has been really helpful.”
But it wasn’t just the EMR that changed Crutchfield’s life, it was the way he used it. He set up a system he calls One Nurse Per Room. With eight exam rooms in his practice and a computer in each room, he has trained his nursing staff to act as scribes inputting all the patient information.
“I have a true physician assistant doing that work for me, and then I’m on to the next patient,” Crutchfield explains. “They’re working as electronic scribes. They’re only inputting what I tell them. I do the complete examination, I do the diagnosis, develop the treatment plan, and then I go to the next patient. The nurse is educating the patient, giving them their prescriptions and entering information into their electronic medical record. That has changed my life.”
Perhaps not as dramatic but no less effective, Colleen Edwards, MD, an internist and hematologist affiliated with Mount Sinai Hospital in New York City, has benefited from using a new EMR platform from Hello Health.
“I live and work in Manhattan, so I walk to work,” Edwards explains. “In the past I’ve taken charts home to document if I didn’t finish in the office. Now I don’t have to lug those charts with me.”
She’s also seen the benefit of the EMR’s doctor-patient interface with instant messaging feature. Patients, she says, are very busy too. This feature cuts down on phone tag, which can go on for several days before Edwards can finally get in contact with the patient.
Edwards says the EMR has also made her a better documenter, forcing her to complete many of the different information fields that she says often fell by the way side.
“My documentation was pretty sparse prior to using the EMR, so this is a good thing,” she said. “I’m not sure it saves you time, but it saves you a headache when you’re audited.”
Making the selection
Crutchfield admits that choosing an EMR can be challenging, with software programs ranging from $25,000 up to $300,000 and beyond.
“There’s a lot of craziness going on,” he says. “Physicians are saying, ‘What in the world do we do? What’s going to serve us the best and not gouge us?’”
The software Crutchfield uses is called Medi-Notes, and it was relatively inexpensive when he began using it. The company charged per physician, so as a solo practitioner his cost was approximately $5,000. But for a large group with 15 physicians, the economics are quite different.
“Some (systems) are billed based on the number of computers that you have the EMR installed on, and others are per physician,” Crutchfield says. “There are a lot of variables. But there are also a lot of good products out there.”
The key, Crutchfield says, is to find something that’s relatively inexpensive; that’s not going to break the bank; and that you can work with.
“You have to [make the switch],” he says. “It’s good in the long run.”