A “Meet the Professor” session at the 47th Annual Meeting of IDSA offered a practical approach to health information technology from two presenters who use some of these electronic tools on a daily basis in their infectious diseases practices.
Using online or e-mailed versions of journal tables of contents, keeping PDFs of journal articles rather than print copies, and using searchable drug interaction databases were among the ways to use electronic tools highlighted by Steven D. Burdette, MD, associate professor of internal medicine at Wright State University in Dayton, Ohio. He also urged caution when looking up recommendations, treatment guidelines, and other medical information on the web. “You’ve just got to be very careful when you do your searches what the source of the information is,” said Dr. Burdette.
Steven K. Schmitt, MD, FIDSA, a staff physician in the Department of Infectious Diseases at Cleveland Clinic, shared advice for how to select an electronic health record (EHR) system. Multiple forces are driving the greater use of these systems, Dr. Schmitt noted, including inefficiencies and duplication, illegibility of orders and notes, concerns over medication errors, record portability, and communication and billing issues, in addition to external forces, such as quality improvement initiatives and pay-for-performance measures.
The American Academy of Family Physicians offers an online reference that includes a list of common functions to help practices organize their priorities before writing requests for proposals for an EHR system. Later in the selection process, other steps can help guide the decision. These include viewing demonstrations from vendors; ranking vendors in terms of cost, function, and service; and checking references. Visiting other sites currently using the same systems can help as well. “There’s nothing like seeing it in action,” Dr. Schmitt said.
The work doesn’t stop once you choose an EHR system. You will need time to refine new work flows, get buy-in from staff, and customize the system for your particular practice or institution, Dr. Schmitt said, in addition to setting aside time for staff training. Additional computers and software, support and maintenance personnel, and extra space are other possible needs.
While EHR systems offer benefits, there can be unintended consequences, including the distraction they sometimes create in the doctor-patient relationship. The additional typing, pointing, and clicking can reduce eye contact between patient and doctor, Dr. Schmitt noted. He also advised clinicians to avoid the tendency to cut and paste information, which can perpetuate incorrect information in records, highlighting the need to verify and update data.
In addition, electronic systems can also push some functions traditionally performed by ancillary staff to the physician, potentially adding time to the workday without additional compensation. “It’s very easy to become an army of one with your computer and your mobile device,” Dr. Schmitt said.
Regulations are another factor driving greater use of electronic tools. Federal legislation passed in 2009 includes financial incentives to implement EHR systems for physicians who treat Medicare patients. For more information, visit the U.S. Department of Health and Human Services website. More information about how to integrate health information technology into your practice, including an EHR comparison tool developed by the American College of Physicians, is available at www.idsociety.org/healthit.htm. (You must be logged in to access this page.)
Audio and synchronized speaker slides from sessions at the 2009 IDSA Annual Meeting are available for purchase online.
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