Electronic Medical Records

Many doctors' offices nowadays have electronic medical records instead of paper charts. My office, for example, is currently in the process of converting over from paper charts to computerized charts.

There are advantages and disadvantages to electronic records. Since my patients are having to put up with a certain amount of delays and chaos in my office during this time period, and are nice enough to be patient with it all, I would like to take a few moments to explain a bit about this whole process.

The advantages of an electronic chart are:

• The electronic chart never forgets anything. Once the doctor identifies a medical problem, it is never forgotten until it is resolved. This is a huge advantage. Other things that used to be forgotten but won't be any more are medications and their dosages, allergies, et cetera.
• Bad handwriting is no longer an issue. The computer's handwriting is excellent!
• The electronic chart is available at remote locations. For example, our office charts will soon be available at the hospital (though they aren't quite yet). This is not possible with a paper chart, which can only be in one place at one time.
• The electronic chart can fax a prescription to the pharmacy while you're still in the doctor's office, so that the prescription is waiting for you at the pharmacy.
• Whereas previously we had stacks and stacks of loose-leaf charts, with wrinkled pieces of paper, some of them torn and falling apart, some of them attached with paper clips, some of them attached with tape, now each doctor just carries around a notebook computer which can bring up all the patient records instantly. There is no longer any need to search through shelves of paper charts.

Disadvantages of an electronic chart are:

• Contrary to what you might think, it takes longer to enter information into the computer than it does to quickly jot down a note on paper. So it's more time-consuming to use a computer.
• Patients tend to get impatient during the visit, watching the doctor slowly enter the data. It seems to the patient that the doctor is paying more attention to the computer than to the patient. One way I deal with this problem is by turning the computer screen around so that the patient can see what I'm doing. That way, the patient and I are in effect entering the data into the computer together. Since most people today are computer-literate, this usually works quite well.

Electronic medical records are the wave of the future. Their advantages far outweigh their disadvantages. Their time has come. The only question is: How smooth will the transition be?

In my office, the transition to the electronic medical record began on August 19, 2003. Immediately, we began to experience disruptions in our scheduling. There have been delays, and there has been decreased availability of doctor appointments. The reason is that the electronic medical record appointments take so much longer than the regular appointments, owing to the fact that we doctors don't yet know how to use the computer system.

On the other hand, all of the staff members have been learning quickly how to use the system, and patients have been quite tolerant of the scheduling delays. By fitting patients into the schedule when necessary, we have been able to accomodate emergencies that have cropped up.

I sincerely hope that the transition to the electronic medical record at your doctor's office is as smooth and painless as possible, and that your health care is not adversely affected by it. The conversion to the electronic medical record is a necessary transition which all doctors' offices must make. In the long run, it is a transition which will benefit patients in every possible way.