Highlands Neurosurgery in Bristol, Tenn., was an unusually early adopter of electronic health records. The practice, which has two neurosurgeons and two physiatrists, installed an EHR system in the 1990s, when it was a beta site for an early system. Today, the practice is still in the throes of adding EHR capabilities. Here Highlands Administrator Carolyn Helton makes five points about what the practice has done so far with its EHR system and what it is still working on.
1. Still using some paper charts. "We've never completely transitioned from a paper chart," Ms. Helton says. While most physicians at the this small practice like to use a laptop with the patient's record digitally stored on it, one physician still prefers print out a paper chart from the EHR and carry the paper into the exam room. During the patient encounter, he likes to write notes in the margin of the chart, which he can refer to when doing dictation afterwards. "It’s a flexible system," she says. "It depends what the physician is comfortable with."
2. Photo of each patient goes into chart. Each patient is photographed at check-in and the image is stored in the EHR system and printed out if necessary. "Having the patient's photo has proved to be very useful," Ms. Helton says. "When the physician is doing dictation at the end of the day, he can refer to the photo to make sure he has the right person." It helps even more when he is trying to identify a patient six months later.
3. Electronic prescribing. The practice has implemented electronic prescribing, but accessing it requires logging onto a website. "We are in the process of integrating this function into the same system," Ms. Helton says. The practice uses a system called DrFirst.
4. Installing voice recognition software. The practice is in the midst of installing voice recognition software that would eliminate the need for a transcriptionist to type up the whole chart. Using the new system, the physician would dictate directly into the voice recognition system, Dragon Medical from Nuance. The transcriptionist would only be needed to edit the text and fill in occasional blanks. However, installation has been slow and frustrating. So far, it has failed to pick up one physician's voice. The software is being retooled to deal with his dialect and breathing patterns. "There is still work to be done," Ms. Helton says.
5. EHR isn't connected to outside world. "We haven't been putting outside information into our EHR system," Ms. Helton says. The practice can access the hospital's EHR system through a secure website, print out the information and read it. It would be easy to set up a scanner to enter information into the system, but so far the practice hasn't had a pressing need to do so, she says. The same applies to information sent by the referring physician. There isn’t much detailed information that must be taken from what the referring physician sends, she says. What there is can be taken from these documents manually.
Learn more about Highlands Neurosurgery.
Read Articles Related to EHR and EMR in Orthopedics:
EHR in Orthopedics: Q&A With Dr. Michael Rauh of UB Orthopedics & Sports Medicine
5 Things to Know About EMR for Orthopedics
5 Points on Adding EMR to Orthopedic Practices
1. Still using some paper charts. "We've never completely transitioned from a paper chart," Ms. Helton says. While most physicians at the this small practice like to use a laptop with the patient's record digitally stored on it, one physician still prefers print out a paper chart from the EHR and carry the paper into the exam room. During the patient encounter, he likes to write notes in the margin of the chart, which he can refer to when doing dictation afterwards. "It’s a flexible system," she says. "It depends what the physician is comfortable with."
2. Photo of each patient goes into chart. Each patient is photographed at check-in and the image is stored in the EHR system and printed out if necessary. "Having the patient's photo has proved to be very useful," Ms. Helton says. "When the physician is doing dictation at the end of the day, he can refer to the photo to make sure he has the right person." It helps even more when he is trying to identify a patient six months later.
3. Electronic prescribing. The practice has implemented electronic prescribing, but accessing it requires logging onto a website. "We are in the process of integrating this function into the same system," Ms. Helton says. The practice uses a system called DrFirst.
4. Installing voice recognition software. The practice is in the midst of installing voice recognition software that would eliminate the need for a transcriptionist to type up the whole chart. Using the new system, the physician would dictate directly into the voice recognition system, Dragon Medical from Nuance. The transcriptionist would only be needed to edit the text and fill in occasional blanks. However, installation has been slow and frustrating. So far, it has failed to pick up one physician's voice. The software is being retooled to deal with his dialect and breathing patterns. "There is still work to be done," Ms. Helton says.
5. EHR isn't connected to outside world. "We haven't been putting outside information into our EHR system," Ms. Helton says. The practice can access the hospital's EHR system through a secure website, print out the information and read it. It would be easy to set up a scanner to enter information into the system, but so far the practice hasn't had a pressing need to do so, she says. The same applies to information sent by the referring physician. There isn’t much detailed information that must be taken from what the referring physician sends, she says. What there is can be taken from these documents manually.
Learn more about Highlands Neurosurgery.
Read Articles Related to EHR and EMR in Orthopedics:
EHR in Orthopedics: Q&A With Dr. Michael Rauh of UB Orthopedics & Sports Medicine
5 Things to Know About EMR for Orthopedics
5 Points on Adding EMR to Orthopedic Practices