With 80% of target family physicians and specialists in BC now using EMRs (85% including practices currently in the implementation process), there are many examples of how EMR technology can produce better patient data and enable physicians to practise more efficiently. Physicians all over the province, in varying practice types are using different EMR systems and are reaping the rewards, including better patient care and professional satisfaction. At the same time, physicians in similar practice types, using the same EMRs, are finding challenges that are holding them back and leaving them frustrated. PITO’s post-implementation support program provides support to EMR users at all levels to resolve issues and maximize efficiency.
Post-implementation support is a practical, hands-on process developed and tested by a group of 500 users over the past year. Practice automation coaches, physician MOA mentors, and EMR vendors can all assist physicians in enhancing EMR efficiency and performing functions that were nearly impossible with paper charts. These include:
• Automatically creating registries, recalls, and reminders.
• Sharing multidisciplinary chart notes and shared care plans.
• Trending and graphing of medications and lab results.
• Tracking drug interactions.
• Tracking incentive billing.
These EMR features can improve patient care in many ways. For example, a compliant chronic disease patient who has been tracking multiple medications herself on an Excel spreadsheet can now track her medications with the help of her physician. Together, the GP and patient can view a comprehensive and up-to-date medication list in the EMR and graph lab values alongside the medications, fostering more accurate treatment decisions and encouraging patient engagement. If the EMR system is linked to PharmaNet, the medication record will be updated if one of the patient’s prescriptions is changed at a hospital, pharmacy, or walk-in clinic. This enhancement will provide continuity of care and prevent medication problems.
Those physicians who have adopted an EMR often report having had an “aha moment,” when they have realized the positive difference the new system will make to their practice, patients, and the overall health care system. Post-implementation support can help physicians pinpoint which aspects of EMR use will be of the greatest benefit to their practice (for more details visit www.pito.bc.ca/support/post-implementation/support).
Dr Gerrit Prinsloo, a GP in Williams Lake, used post-implementation support to change his clinic’s workflow process and considered it an amazingly positive experience. Expanded EMR use was the key to changing office procedures that had been in place in his practice for 30 years. Dr Prinsloo’s practice automation coach arranged for “super-user” Dr Erin Ewing to spend a day helping Dr Prinsloo’s team, which resulted in all users achieving a higher level of EMR use.
In White Rock, GP Dr Robyn McKnight worked with a practice automation coach to create a customized action plan—a roadmap—to maximize her EMR capacity, something that she continues to work on each week. Dr McKnight’s revelation about EMR efficiency happened when she discovered that using templates could save her time and provide more consistent data.
While more and more clinics are optimizing their EMRs, a number of physicians and communities are involved in innovation and diffusion projects—pilot projects pushing into the next big areas of EMR use such as e-referrals, data exchange between physicians, patient portals and personal health records, and community-level primary care indicators (for details visit www.pito.bc.ca/support/communities-of-practice/idp).
These examples demonstrate the value of recording coded electronic records and maximizing the use of your EMR, and the importance of interoperability of data between EMRs. Using EMR data to collaborate with colleagues, hospitals, and other community care providers has had a powerful impact on individual and collective patient health in the province. Witnessing these improvements in care allows physicians to feel empowered and confident in day-to-day practice, and creates a sense of optimism about what they can accomplish.
—Bruce Hobson, MD
Co-chair, PITO Steering Committee and Physician Practice Leader, Practice Support Program
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