A Visit With My Primary Care Doc and His EMR

I just returned from visiting my family practice physician for my annual physical.  He is a forward thinking guy, and took the plunge several years ago by purchasing one of the leading EMRs at considerable cost to his solo practice.  

As he queried me on my health status (diet-good; exercise-room to improve; fatigue-are you kidding me, I work in health IT), I quizzed him on how he was using his EMR to exchange chart notes with other providers, one of the key objectives of meaningful EMR use.

What I learned did not surprise me, and reinforced how far we have to go to achieve electronic exchange of PHI.

Me: I’m going to assemble a personal health record for each member of my family, and I’d like to get a copy of our chart notes in electronic format.  Can you do that?

Dr: Hmm, I have no idea.  No one has ever asked for an electronic copy.

Me: How do you send patient notes from your EMR then?

Dr: We print them and then give to the patient or fax to another provider.

Me: Have you heard about personal health records?  Does your EMR allow you to upload them to Microsoft HealthVault or Google Health?

Dr: I don’t think so. I have no idea.

Me: How do you get chart notes from other providers?  Can you download them to your EMR?

Dr: No. Documents are faxed.  It is really frustrating.  For example, both hospitals I admit to fax me.  My office staff then scans the print copy into our EMR.  Fortunately, they are really quick at doing this.  One of the hospitals just changed systems, and that made it worse.  We used to be able to cut and paste from their notes into our EMR, but we can’t do that anymore.  Notes scanned into the EMR are barely readable, as the type is way too small.  So honestly, I really don’t even look at them.

Me: There is an easier way.  You should rarely have to use your paper fax machine.  For starters, you should be able to fax chart notes directly from your EMR.  And for incoming faxes, at the very least, get an electronic fax number so you can upload the file into your EMR.

This workflow is costing my doctor thousands each year in office supplies and productivity of his office staff, not to mention his time.  He told me that he wishes he could go back to dictating into his EMR. (He can with structured narrative notes.)  These are exactly the types of problems we help our clients solve every day.