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Integration of the Back Office With the EMR.

These days, the hot topic of discussion in medical practices is electronic medical records (EMRs) and the transition to a totally paperless environment. While many EMR companies tout superiority in achieving a paperless process for both front and back office operations, most fall short. The result is that today's medical professionals continue to search for plausible solutions.

I believe that one of the barriers to the successful implementation of EMR systems is the lack of understanding about medical practices. Specifically, understanding the significance of diagnostic tests and the instrumentation to perform those tests is the starting point for analyzing the critical elements of patient care, as well as the integration of information from the back office into the medical record.

Taking a step back to look at the operation as a whole helps to identify the key factors. The doctors' processes at the office consist of more than just scheduling appointments, sending and receiving e-mail, prescribing prescriptions and completing insurance forms. Medical practice requires the execution of a variety of medical tests such as ECG, Holter monitoring, lab results, spirometry (lung), stress testing, weight measurement, blood pressure, temperature and vision testing. The ways in which these tests can most effectively be administered in conjunction with the EMR should be a major point of discussion when it comes to determining possibilities for the exam room of the future.

Can we effectively address these issues? Can these tests be completely integrated with clinical information systems? Are there true benefits to both the doctor and the patient, sufficient to warrant the investment of time and financial resources?

Exam of the Future

To examine the impact of diagnostic tests, let's look at the ECG. Every eight seconds another one of the 76 million Baby Boomers turns 50. According to "Managed Care Trends" provided by Medical Data International, there are currently 30 million ECGs performed every year--and the expectation is for more than 72 million ECGs to be performed per year by 2010. Additionally, more than 4 million spirometry tests and 4 million Holter tests are conducted every year.

Moving toward digital documentation is essential when we consider that 95 percent of patient records are still recorded on paper, with 30 million pieces of ECG recording paper and mounting cards accumulating every year in patient files across the country. In addition, nurses typically must copy all of that paper and then scan it into the electronic medical record. Healthcare managers must find ways to reduce the costs associated with performing this testing to most efficiently process and store patient data.

Now, imagine a trip to the doctor where, upon entering the exam room, the first step you take is onto a scale that digitally records your weight into your EMR. Unlike traditional medical devices, the devices of the future will have the built-in capability to take the patient's blood pressure and temperature, and to perform tests--pulse oximetry, ECG, Holter test, spirometry, vision and stress tests.

Next, imagine an exam room offering computers that accept all of this diagnostic information. The monitor could be on a wall to conserve space or strategically placed in other areas of the exam room. Plus, doctors can utilize these systems to further enhance the patient examination experience.

During periods in which patients wait for the doctor to examine them, they can peruse medical reference websites or even check their e-mail accounts. Patients also could be encouraged to take a proactive approach to their own healthcare needs by investigating specific topics such as weight loss or other pertinent health concerns. Medical practices could also use this time to have patients complete and submit digital surveys to collect information about perceived health status and patient preferences.

Today, physicians can conduct ECG or spirometry testing simply and easily without scanning. Using digital handheld devices, pentops and laptop devices that plug directly into the computer, the tests are completed and results are saved digitally in the EMR.

This data can then be sent anywhere in the world via secure e-mail for others to instantly review. Not only is paper completely eliminated from this equation, but information is also instantly stored and immediately accessible. Most importantly, physiological tests and the EMR are wholly integrated for increased functionality, efficiency and flexibility. Only one computer is necessary to conduct and save all of the patient tests and records. The final result will be that patient care is improved while medical costs are significantly reduced because information is recorded digitally and accurately at the source and office efficiency is simultaneously optimized.

The Right Digital Start

When considering ways in which medical practitioners can transition from paper-heavy environments to digital formats, the solution becomes quite clear. Through the implementation of digital diagnostic devices that record and store a patient's physiological data directly into an EMR, many benefits result. The key to implementation is to begin archiving transitions in the office digitally. Once this process begins, the transition to an EMR system will be smooth and successful.

Digital diagnostic technologies ensure that a patient's physiological data is accurately obtained, effortlessly documented, protected and easily transferred electronically. Offering significantly more functionality when compared to traditional devices, users can experience a dramatic reduction in the amount of time and money required to collect patient data and to maintain patient's health records. By making the exam room the foundation in which all of these devices are integrated, the solution is invaluable. Medical devices designed for optimal patient comfort, maximum efficiency and the transmission of digital information can be the ideal solution for complete integration in the 21st century.

Michael D. Paquin is vice president of business development for Brentwood by Midmark, Torrance, CA. Contact him at mpacquin@
COPYRIGHT 2001 Nelson Publishing
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Copyright 2001 Gale, Cengage Learning. All rights reserved.

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Author:Pacquin, Michael D.
Publication:Health Management Technology
Geographic Code:1USA
Date:Sep 1, 2001
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