| "Everything we did, we had to figure out a method to accomplish the same task with a computer instead of with paper" Family Medicine Physician Paul Smith |
Industrial and Systems Engineering Professor Pascale Carayon (right) looks on as Dr. Paul Smith of the Belleville Clinic updates a patient record in the clinic's new electronic media records system, which Carayon helped implement. (Photo by Bob Rashid)
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A pharmaceutical company just announced that it will take one of its medications off the market, and doctors must quickly alert all of the patients taking that drug and prescribe a substitute. But in a clinic that keeps monster-sized filing cabinets filled with patient charts, they will face a search akin to finding the proverbial needle in the haystack.
"That's absolutely impossible with a paper record," says Dr. Paul Smith. "With the electronic medical record, I can sit down at the computer, do a quick search and find every single patient who takes that medication."
A family medicine physician, Smith hopes an electronic medical record (EMR) system will help his small Belleville, Wisconsin, clinic improve the services its doctors offer.
The EMR system places networked computer terminals in key clinic areas, including nurses' stations, doctors' offices, exam rooms and at the front desk. It enables clinic staff to create, file, edit and retrieve patient files on a computer, and replaces paper charts with electronic files. Office staff can access the files for check-in, patient call-back reminders, billing and other activities. At the same time, medical staff throughout the clinic can enter, view and share such information as medical history, vital signs, test results and prescriptions.
Implementing the EMR system in the Belleville Clinic wasn't as simple as installing a few extra computers, however. "All the documentation, all the paper-writing, typing and printing that we do every day is now done on a computer," says Smith. "It's hard to change the system — and this was incredibly complex."
He hired a project manager, formed a team to plan the implementation strategy, and enlisted Industrial and Systems Engineering Associate Professor Pascale Carayon as an advisor and process evaluator.
She designed the study not only to aid the Belleville Clinic, but also to produce data and methods she can apply to many clinics facing a similar situation. "It was very much a joint effort," says Smith. "She and her grad students did a lot of the basic work and then I just helped with the refinement part and making it applicable to this project."
A major part of the group's plan involved conducting a two-week work-study analysis. "Every half an hour, we'd make an announcement overhead and everybody would stop what they were doing and write down what they were doing, who they were doing it with and why they were doing it," says Smith. "Everything we did — every process — we had to figure out a method to accomplish the same task with a computer instead of with paper."
Carayon also surveyed clinic staff about their job satisfaction, work resources and perceptions of and expectations for the new technology, then compared their replies to the implementation team's goals. When she learned that most Belleville Clinic employees didn't know what to expect, the team added staff communication to its agenda. "Letting people know what's going on and involving them are big things that any institution or organization can do to try to reduce that resistance to change," Carayon explains.
The clinic recently "went live" with the EMR system. At the six-month mark, Carayon will undertake a second round of data collection to assess the implementation process, workloads and staff attitudes toward the technology. Smith is looking forward to the results. "It will be really interesting because she has a very different perspective about how to interpret things and what it means," he says.
It may be some time before the clinic realizes all the benefits of the EMR — but it's worth the wait, says Carayon. "They are looking at that as a huge investment to improve the medical care outcomes, their efficiency and their effectiveness," she says.
--By Renee Meiller--
| For further information, please contact: |
Pascale Carayon, 608/262-9797
carayon@engr.wisc.edu
Copyright 2001 The Board of Regents of the University of Wisconsin System
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Date last modified: Thursday, 31-May-2001 09:06:25 CDT
Date created: 31-May-2001
