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EHR? Count me in!

Here are some advantages:

	I can rapidly transfer the most recent office note and a full history by fax or e-mail in a very legible format. When I send a patient to our oncologist, orthopedist, or another clinician within our system, all records are available for immediate review.

	I can set the EHR to provide reminders when tests are due. If I want to repeat a PSA in three months, for example, the EHR will supply a pop-up reminder at the appropriate time. Using the EHR reminder system, our medical group has increased our annual mammography rate from under 70 percent to close to 100 percent.

	I can easily check laboratory data, diagram results for chronological review, and make copies for patients so they can track their progress. I find that giving patients written data on their problems and goals motivates them to do better.

	I can give traveling or transferring patients concise and legible summaries of their medical history. Want a copy of your problem list, meds, and allergies? Let me print that for you right now.

	I can determine how well I'm managing a class of patients. For instance I can pull all of my diabetic patients and review their hemoglobin A1c readings, see where my average is, and identify outliers.

	I can do medication recalls swiftly. Within 12 hours of the announcement that Vioxx had been withdrawn from the market, our system had identified all patients on the medication and had sent letters telling them to contact their physician.

	We've established a long list of best practice guidelines, and the EHR reminds me to meet recommended standards.

	Patients now have limited access to their records via a system we call My Multi-care. This helps with updating medications, reviewing laboratory data, and scheduling appointments.

Do I love all aspects of the EHR? No. There are still some bugs in the system. Was it a struggle to get here? Yes. And yes, it's frustrating when the system goes down on a Monday morning when patients are lining up to be seen.

Still, I now have better, more-accessible, and more-organized patient records, and I anticipate further improvements and efficiencies in the future—we're working now on an EHR response to critically abnormal lab values that will require action before the aberrant result can be filed. The way I see it, the challenge for clinicians is to take the lead as the EHR develops. We need to make certain it remains foremost a clinical tool, helping us do our jobs and provide good care. It's too powerful a mechanism for us not to maintain control over it.

And yes, Dr. Davant, you can easily tell an EHR to remind you to ask about a patient's new grandchild or tasty tomatoes at his or her next visit.