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“The patients love ChartWare EMR, and I love it, too. ChartWare EMR is probably the best investment I've ever made ”
Dr. William Marsh Customer Since 2003 |
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Record Keeping System Cuts Repetitive Work for Doctors
Dr Jonathan Pierce, Grass Valley, California
"Doctors are paid for seeing patients face to face and making decisions to improve their health. They arent paid for doing paperwork or being on the telephone or hunting through charts," says Dr. Jonathan Pierce, an internist in Grass Valley, California. "Yet primary care doctors spend hours a day outside the exam room on these kinds of tasks," he adds.
"Once a decision has been made and expressed, a doctor shouldnt have to go on expressing it. All that repetitive work - writing up his note, then filling out a prescription separately, then making sure an entry is made in the medical log, then faxing a prescription to the pharmacy - takes him away from what he really should be doing."
For years, Pierce says, he wanted to find a way to cut out this time-consuming work. "When I went out of the room after seeing a patient, I wanted everything to be finished."
Now, by computerizing his record keeping, he has largely achieved that goal. "I use my time with a patient to diagnose the problem, set up a treatment plan and thoroughly document what Ive done. When the visit is over, all the steps that need to be taken have been recorded and are ready to be sent to everyone involved. That includes a report that the patient takes home saying, among other things, what his diet should be, what changes in medications Ive made and what follow-up actions he needs to take, including referral telephone numbers to make calling them easy."
"As any doctor knows, its very stressful, when doing repetitive work, trying to remember if you copied information in all the necessary places, particularly when immediately after that visit you are seeing another patient with a whole different set of problems. If you can integrate all the aspects of record keeping into one work motion, the problem is solved."
But Pierce says he also needed another feature in a computerized system. "Doctors are all very individual," he says. "They all have their own way of doing things. So the system has to be completely modifiable to suit all individual needs."
Thats when he came across ChartWare, the software company based in Rohnert Park, California, which another local doctor enthusiastically recommended to him for its flexibility and which was awarded five stars by Family Practice Management, journal of the American Academy of Family Physicians. "Its given me just what I was looking for," Pierce says.
In his own solo practice, Nevada City Medical Office, for example, where he sees an average of 22 patients a day, he does a lot of injections for musculoskeletal problems. "Im not a geek but I just went in and modified my note outline so that, for a dozen different injections, a complete description of the procedure is rapidly generated: the medication dose given, how I sterilized the area injected, how the patient reacted, whether I got informed consent and so on. With just a few taps I have everything on record, even a printed bill."
Pierce is particularly pleased that compliance by his mostly elderly patients has improved with his use of electronic records. "With their multiple problems, large number of medications and frequent testing, they can get very sick if they dont follow the plan. Yet telling them what to do verbally or piecemeal is bound to lead to misunderstandings and neglect."
The note is not only more complete but more orderly. "In primary care, almost every patient comes in with more than a single problem and then tells the story in a disjointed fashion, jumping from current symptoms to family history or medications and back again," Pierce points out.
"Collating disparate information rapidly and putting it in a planned form is a problem as old as medicine. With ChartWare, I simply move between different parts of the note outline as the patient changes subjects, tap once, make an entry, then go back when the subject changes again. At the end, its all there, accessible at any time."
He had a striking demonstration that his patients like it too. For a week when he was upgrading the system, his printer was out of service and he went back to writing out his instructions. "One after another, patients asked me Wheres the summary, doc? You arent giving it up, are you?'"
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