EMR In PCSM

What is this alphabet soup I’m offering up today?

EMR

EMR, here to stay.
How does it impact
patient/doctor relations?

I wanted to discuss “Electronic Medical Records in Primary Care Sports Medicine.”  In other words, “EMR in PCSM!”

I’m just wrapping up a busy Friday clinic and finishing typing up my notes as I transition to typing up these thoughts on the WordPress blog site.   Doctoring these days involves a lot of typing on the computer! Here at Sports Medicine, Nationwide Children’s Hospital, we use the EPIC EMR system.

I was prompted to write about this issue today, and find out who out there in the sports medicine world is using EMR (or perhaps in 2013 the pertinent question may be who out there is NOT yet using EMR), by a  fine article I read in the L.A. Times:   “So much data-gathering, so little doctoring.” 

I began my career in medicine in the early 90’s:  six years after finishing up my undergraduate education, I started medical school in September 1991.  I recall having an email account in medical school, but it wasn’t until my final year in school that I heard about hypertext or the world wide web.  And there certainly was no EMR, at least for me, in the 90’s.  I was writing in charts or, better yet, dictating my notes.  This is how medical documentation remained for me until 2005, when I spent a few months doing locum tenens work in New Zealand.  I recall showing up my first day at the GP clinic in Matamata, on the North Island of NZ, and the clinic doctor whom I would be working next to asked me if I had ever used EMR.  I said no, and was hoping I might have some option to chart on paper.  He smiled and very civilly told me, more or less, to keep a stiff upper lip and just get on with it.  There would be no paper for me, I’d learn on the fly.

As an aside, now having worked in NZ twice in my professional career, may I say that that country is a leader in the field of what EMR implementation can achieve.  NZ continues to work on EMR integration.  I found in my time there that the song and dance of the American medical system–having medical records faxed from the clinic 10 miles down the road; the MRI transferred to a disc that then must be shuttled hand to hand, trying to read an illegibly written note, etc.–was a rare occurrence in NZ.   It was much easier to take care of a patient ‘out of network’ in NZ than it is in the USA.

UCSC_Meadow

The view from the
University of California, Santa Cruz campus.
Yes, it really is that beautiful.

On my return to The States, I discovered my clinic at the University of California, Santa Cruz was ready to implement EMR.  While my colleagues mostly moaned and wanted to drag their feet, I had, I believed, already seen the light.  No more need to track down a missing chart, no more need to decipher a doctor’s handwriting, EMR was the way to go.  And from that point on, for the last 8 years, I have only used EMR in the various positions I have held.

But there is a dark side to EMR.  Getting back to the L.A. Times essay, I found this piece to be, overall, an insightful, provocative and short essay exploring this side.  Many things stood out for me, most especially this paragraph: Read more of this post

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