computer savvy colleagues. Also, resident
physicians are a wonderful source for
templates. Many doctors have a standard
admission H&P and leave “spots” for
adding details to the HPI, Past History,
ROS and Physical Exam areas of the EMR.
Similarly, most doctors have a standard
Admission Order Set and then order
subsets for specific conditions – e.g.,
heart failure, glucose control, pneumonia,
sepsis, etc. – which can be added in as
needed. As you use these sets more
frequently, you’ll get faster and also find
the spots that slow you down.
Make note of these “potholes” and try
to systematically fix them to run more
smoothly down the road.
Keep It Simple
The best templates are short and
sweet. You aren’t writing War and Peace
and besides, no one wants to wade
through your voluminous notes anyway,
especially YOU! You’ll want to balance the
“sensitivity” of your templates (template
covers the average situation) and the
“specificity” (template includes the needed
verbiage for selected clinical situations)
to maximize the time saved AND minimize
the space used in the chart. For example,
rather than importing all the lab results for
the day into your Progress Note, consider
just mentioning the lab values used in your
decision making. According to Dr. Dike
Drummond of TheHappyMD.com, unless
what you’re typing supports continuity of
care, billing, or legal documentation needs,
then don’t put it in the chart. Less is more
when it comes to charting.
Ask for Help
“No man is an island,” and don’t feel
that you are stranded on one. Don’t
struggle; ask for help early and often.
When the hospital brings in a new
computer system, be certain to maximize
the super users and help staff who are
available pre-launch and the first few
weeks after. Spend some valuable time
with these dedicated helpers having them
personalize your templates and order sets.
It is better to experience an initial deep
gash and recover after the first week than
to be assailed by a thousand cuts over the
next 3 months! Also, be certain to identify
the nurses and your colleagues who are
coping well with the new system, so you
can find help after the honeymoon period
is over. Again, resident physicians are
great in this situation because they can’t
ignore you! There’s nothing like “dedicated
help,” right?
The Office
Most physicians lose 15-20% of their
productivity for 3-4 months when instituting
an EMR. Don’t be a statistic; follow these
tips: 1) Have your staff develop a template
from your old charts - why reinvent the
wheel? Use the same strategies described
earlier to set up personalized New Patient,
Annual Visit, Consult, Follow-Up and
Procedure forms as desired, 2) Train your
Dragon -use voice recognition software
to fill in the blanks on your forms, and 3)
Hire a scribe – using a scribe to follow you
in the office and handle your charting will
save your productivity while allowing you
to learn the system over time. A nurse
or even advanced students in nursing,
premed, or medical coding make great
scribes. Your productivity savings will more
than cover the cost.
Using these tips will hopefully make
transitioning to an EMR less painful than
a wisdom tooth extraction and may even
allow you to embrace the idea – well,
maybe later… DMJ
June 2020 • DALLAS MEDICAL JOURNAL 7