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EMR Reference
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Purpose :
Since the Division of General Medicine at UMDNJ - New Jersey
Medical School piloted the Logician Enterprise electronic medical
record (EMR), we have been anxious to explore the seaming unlimited
potential of the system.
These subsequent pages are a challenge to our information systems
and ourselves. We intend to use this initiative to redefine
our efforts in providing patient care, providing health care
education, participating in medical research and giving our
community service.
Background :
UMD Care is the general medicine practice of the University
Hospital in Newark, NJ. It is serves more than 25000 patient
visits per year. Acts as an outpatient care site for more than
36 house staff and 10 attending physicians. These providers
spend anywhere from 4 hours per week to 36 hours per week caring
for patients. Various students rotate through the practice continually
as part of their formal education in patient care.
Patients have always been seen by provider staff in the examination
rooms, this did not change. Most reference materials were kept
in a central work room where cases could be discussed and information
looked up in texts.
Beginning in May, 1997 a large renovation was begun to the
facility and to the work flow. Glass partitions between patients
and staff were removed. The waiting room capacity was decreased
by 40% and that space was given to staff for expediting the
patients paper work through the procedural process of the practice.
Every exam room, employee desk and work space was provided a
Pentium computer with access to key online information services.
Attending practice went live first, followed shortly there after
by the resident practice.
Our practice saw its wait times decrease by 30% and the number
of patients seen increase by 25%, while it saw small omissions
in programming hinder certain other services. We learned quickly
to concentrate on what worked and avoid what hindered.
Our Information Services Department found the demand for the
system challenging to meet. They rolled out practice after practice.
Some practices embraced the system, others thought they would
and did not. As each practice fed more information into the
system, our practice's dependence on the system grew. We wanted
more and more services from the system. Practices that did not
initially embrace the system found that the fellows they recruited
from our practice would insist on using the EMR. The culture
of each practice changed from within and without as students
climbed levels within the system. More and more physicians,
who thought the system cumbersome, are rediscovering it now.
This represents the next phase of development. It is a test.
We are redesigning our EMR's work flow and forms to both educate
and facilitate.
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