Speak Out: Are you happy with your EMR system? Why or why not?

“I think the EMR is helpful in some regards; however, I find it cumbersome in some respects, such as data entry. There are so many different systems, and that’s part of the issue. We use three different systems in our practice-one for one hospital chain, one for another hospital, and one for our office.

Our group has had EMRs for 25 years; we were in on that early. The one we started with here was an easy system to use, but it is a dinosaur as far as the systems we are required to use to meet the meaningful use requirements. The two hospital systems don’t work together at all. It’s very fragmented.

I like that I can use Dragon NaturallySpeaking [speech recognition software]; I input a note and it’s done and signed and off to the referring physician. Using the EMR does take more time when you’re with the patient, which I don’t like. It is, however, available for all the other health care providers immediately.

If I had the choice, I would go back to our original EMR, but it just doesn’t meet government-mandated uses.”

C. Ryan Barnes, MD

Richmond, VA

“I like my EMR. The advantages are that the record is always there, there are no lost records, there are no handwriting issues. There is a lot of decision support, such as suggested clinical practice guidelines; it will pick up allergies and drug interactions; and in a large group it means everybody can see the records. I can see what the allergist is doing, what primary care is doing, what the cardiologist is doing, and they can see what I’m doing. It also helps with coding.

It does put more work on the doctors, in that, instead of yelling out the door, ‘send the patient up for such-and-such a test,’ now I have to actually put the order in the chart. It’s taken some of the work done by ancillaries and put that on the doctors.

Short, quick visits take longer than they should, on paper, but long, complicated visits will go more quickly with electronic medical records.

I don’t know what it would be like if we had to deal with hospitals that had different systems, but here at Kaiser we’re completely integrated.”

Charles Shapiro, MD

Los Angeles

“I’ve been using the EMR for a little over 2 years, and it’s something of a love-hate relationship with our system. It definitely takes longer to get things done when you’re seeing the patient. It can in no way handle modifiers or procedures. It slows you down tremendously in the office. If you order a PSA test, the file can’t be closed until the results of the test are entered, and that can take a day. It wants height, weight, and BMI for every visit-even weekly, or you can’t go on, so there is unnecessary duplication. There is also constant upgrading and trying to get new templates. It’s a system that wasn’t designed for what it is being forced to be used for. The urologist wants one thing, the ENT needs something else, and the cardiologist, something different.

It does help in getting information from previous visits or from other doctors. That is definitely an advantage because that information is more readily available.

I like trying new things and am not ready to give this up, but it does need a lot of work and I don’t know if it’s going to get where it needs to be, to what we really would like it to do.”

Charles F. McKiel, Jr., MD

Chicago