I read with interest the response by Dr Fox. I
too, like Dr. Fox, would have a brief patient
info sheet, then a privacy policy. I would see
the patient in consultation/treatment room also,
and do a more complete H&P. I would document
these findings in my chart and then dictate my
complete and final note. It's pretty efficient
and highly effective. However, now that I have
made the jump into EMR, I somewhat feel Dr.
Borreggine's pain.
Take medications as an example. To meet
meaningful use it's simply not enough to list
medications. You must list the complete list of
meds taken by the patient, as well as dosage and
frequency. In some patients that can be quite a
list. Once these patients return to the office,
it's not as labor intensive to update the
medical history, meds, etc., but the first time,
it is quite a task.
All my patients now, when confirmed the day
before, are asked to bring in a complete
medication list with dosage and frequency. Now
that more and more PCP's have EMR the list is
easy for them to get. if not they have to write
it all down. I also ask them to download the
patient info form from my web site (which is
brief). It is more time efficient when they get
there, and if they are elderly and "don't do
computers" my patient intake is brief so they
have their meds already with them and the intake
simply asks the necessary info (name, address,
insurance, etc).
That alone will take some of the hassle out of
filling the forms out in the waiting room. I
have put a sign up in the office explaining to
the patients we are turning over to EMR and
while this may take a few more minutes, please
understand, in the long run it will be far more
efficient.
I have trained one of my staff to input not only
medical history and allergies (which is simply
point and click) but also medications. I simply
do not have the time to input all that info,
fill out the EMR PROPERLY to meet meaningful use
then, oh yes treat the patient. Once the
patients return for folllow up this process
flows much easier.
So to Dr. Borriggine, try to streamline the
intake, and to Dr. Fox, if you are doing EMR I
admire your efficiency if you can input the
entire medical history, meds, allergies, problem
list, pharmacy, social history, and allergies
yourself.
Frank Lattarulo, DPM, NY, NY, doclatt@aol.com
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