by Danny Kraftcheck, MD, OntarioMD
Republished with the permission of OntarioMD
I certainly learned some valuable lessons for succession planning when my partner retired. The foremost was that adopting an electronic medical record (EMR) could help me realize my goal of providing a smooth transition for my patients to a new physician.
Over the years, my partner and I accumulated a large wall of charts bulging with clinical notes, labs, X-rays, consults and countless other documentation. My partner brought in a number of prospective physicians to assess his practice. It became quite obvious that one look at our thick paper charts turned them off immediately. Younger physicians are used to the digital world and the thought of deciphering handwriting and sifting through piles of paper was not how they wanted to start practice.
In order to avoid the same scenario, I decided to convert all my paper charts to an EMR. While initially daunting, the critical success factors for my transition from paper to electronic records was having a well thought out plan, advice from an OntarioMD Physician
Peer Leader, and change management support from two OntarioMD practice management consultants.
The process was relatively painless and completed in nine months. I carefully thought about what I wanted the outcome of the transition to electronic medical records to look like. My plan for the transition from paper to an EMR was to have the process reflect how I traditionally practised. I was adamant that I did not want my normal interaction with patients to change. I wanted to physically examine patients when appropriate. I wanted to maintain eye contact and not be distracted by a computer screen or by looking down at a keyboard. How would patients react to the change? How would my staff react to going electronic? I needed them to buy into the benefits. Their involvement and commitment would be critical to our success.
Since I couldn’t type well, the ideal solution for me centred on considering voice-activated software with commands that approximated my usual routine. I purchased one of these products and tried it over a weekend. I was very surprised that there were so few mistakes. I was convinced that this was the way to go for my practice. I chose to use the voice-activated system, with a funding-eligible EMR from OntarioMD, in each of my three examining rooms and central workstation. I set up commands that aligned with various patient scenarios, for example, annual physicals for various age groups, diabetic follow-ups, abdominal pain, etc. Patients heard what I was dictating about them and felt more engaged during their visit. This was another benefit of EMRs over paper.
In addition to the advice and support I received from OntarioMD, I greatly appreciated their funding assistance. I also made the decision to pay for regular monthly IT support. This turned out to be an extremely worthwhile investment as it took all the hassle out of thinking about how to maintain hardware, software, backup, anti-virus protection, etc.
With more than 40 years’ worth of patient charts, there was no reasonable way to have everything scanned for the EMR, yet I didn’t want to lose important historical clinical information. The solution was to incorporate all clinical patient profiles (CPPs) and to include the last five pages of clinical notes for each patient. Depending on frequency of visits, for some patients, this represented a few months of data; for others, a few years. Once this information was in the EMR, it was rare for staff to ever have to go back to the original paper versions.
I soon saw other benefits of using an EMR. Staff was able to find patient information more quickly. There was much less faxing and handling of paper. It was easy to transfer information to consultants. Allied staff in our group could access and read each other’s information more readily.
We were able to complete the task to become electronic before any prospective new physicians came to evaluate my practice. As it happened, the first candidate that came chose to stay. The EMR was certainly a deciding and critical factor in her decision. Our transition period lasted 18 months, during which we shared the practice. This allowed patients and staff to get comfortable with the impending change.
Ultimately, I had no doubt that my patients now had a well-trained physician who would provide them with excellent care assisted by complete and legible information and I was able to eagerly embrace my retirement goals!
While it may seem counter-intuitive to switch to an EMR just before retirement, the switch made sense because the process was relatively easy and a boon for my patients and staff.
Dr. Danny Kraftcheck recently joined OntarioMD as a Physician Peer Leader to mentor other physicians to transition to an EMR before retirement.