Feature April 26, 2012 David Rossi

3 essential qualities of a robust EMR

With all the incentives and push to go electronic, Urgent Care still hovers around 50 percent when it comes to usage of Electronic Medical Record (EMR) systems. Why? It’s an electronic age in which iPods and phones rule the landscape, and physicians are amongst the top when it comes to using them; however, when it comes to electronic records, many of the reasons behind the lag in adoption are obvious and understandable.

Trusting that the urgent care software solution will really improve efficiency, instead of slowing me down. If I currently use chief complaint-driven paper templates, where my charting is comprised mostly of quick pen strokes, how is software, with its plethora of features, multiple screens and continuous “loading” icons, going to be even as fast a charting method, let alone faster? So, the real issue is ease of use and speed. How can I improve speed and efficiency by going electronic? Isn’t it going to make things slower, more cumbersome, and consequently drive profitability down?

If you’ve developed a particular way of doing things over many years of using paper, then changing to an electronic system might not only dictate how you’ll practice, but also require downtime for you and all the medical facility’s staff to implement, learn and ultimately switch over to the new system. So, “If it isn’t broke, don’t fix it”, right?

Where are the records? Are they secure, and do I have control/ownership with regards to who can access those records? With paper charts, they are stored in my facility, under my supervision and control. If I store them electronically, then do I put myself and my patients at risk?

These are just a few of the reasons why it makes it easier to just stick with what we know has worked. The government incentives out there don’t really entice me, nor do I trust that the money promised will ever make a dent in my expenses to go electronic.

Now, let’s look at Urgent Care and what that’s supposed to look like. Urgent Care is designed to help those who need episodic, unscheduled care. It’s often high traffic with the need to be seen and cared for quickly. In many cases, an Urgent Care facility will see well over 50 walk-ins per day. So, I must have a system that’s going to address quick registration and fast efficient charting, as well as sending and receiving orders, providing discharge instructions and writing prescriptions. I may also want to send the patient to a specialist, as well as give the patient and the follow-up physician instructions and/or a summary of orders and care given during the initial visit.

So, the question for Urgent Care is, “how am I going to do all of this and see at least 50 patients a day”? If you’re seeing 50 in an 8 hour period, then you need to be able to care for and chart each patient in just under 10 minutes. On average, most EMRs take 20+ minutes per patient just to chart. So, what do you do with the other 50 percent of your business? Do you hire more people, save the charts for after hours, or invest in an EMR that’s streamlined to meet the real needs and affordability of Urgent Care.

If we address the speed, then we still need to consider the other two areas of concern, change and risk.

Change needs familiarity and support – The ability of the software to be customized to mirror your flow, process and templates is crucial, because familiarity breeds confidence for learning and usability. Equally important is the training and support provided to assist you with these customizations.

Risk needs security and accuracy – You want a software package that’s going to offer you flexibility in terms of where your files are created, stored and backed-up. The software also needs to be easily customized on the fly, so accuracy and saved preferences are easily cued up for future use.

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