Dr. Roy W. Smith, MD, CCFP, FCFP
Meadowood Medical Centre, Winnipeg

My EMR experience
In 1981, I began practice in St. Vital using paper booking billing and medical records, which was the norm. The process of manually reconciling the billings was quite onerous. In 1991 we installed a scheduling and billing computer system. This greatly eased the billing and reconciliation process. By 2001 this system was obsolete and needed replacing. Our physicians were interested in an EMR and we decided to investigate the options. We made a list of which features we needed, and toured clinics in Winnipeg, Winkler, Morden, and Steinbach that were using the potential products. By asking both the physicians and the staff about their systems, the implementation process, and their experience since implementation we were able to choose a vendor and plan for implementation.

Going Live
In December 2002 we went live with the EMR and for the first year I spent an extra hour each day entering past medical histories, medications, allergies, immunizations and family histories into the record for the patients I saw. That first year of learning the system and entering enough data to make the system useful is work. Since then, patient visits have been much more efficient.

Features I find the most efficient:

1. Prescription repeats are just a few mouse clicks.
   When I prescribe a drug the Rx is printed for the patient to take to the pharmacy, and recorded in the encounter note and the prescription database all at once. I no longer had to write out the prescription and then rewrite all the same data into the chart.
   
   
2. Filling out forms is very much faster.
   The computer automatically enters all the demographics, and also any other chart info (for example on a Diabetic Education Referral the most recent FBS, HgA1c, Lipids, Ht, Wt, BMI, and current medications are automatically entered). On many forms, like consults, x-ray requisitions and WCB forms I can just cut and paste in my SOAP note and the requisition is done. I have saved time and the information sent is complete.
   
   
3. Finding information is fast.
   First, I never have to look for the chart – and it never gets misfiled. Finding a specific x-ray or consult letter is just a few clicks. Getting a list of all Blood pressures, all weights or all diabetic lab results is just one click. This means I can review data quickly and make better decisions for patient management.
   
   
4. Storage of records is efficient.
   All of charts for seven doctors for five years practice is 12.2 GB and the images (scans of consult replies and reports is 26.25 GB) This means all of these reports take up only a portion of one hard drive. Since I went electronic I have not kept any paper. All the paper results, which come in, are scanned into the EMR. Of course I still have 20 years worth of paper charts from before we implemented the EMR.
   
   
5. Remote Access.
   I can manage information from home or even while on holidays. In fact one of our doctors is spending the year in Germany and most days logs on to review her patients results letters and give her receptionist instructions on what to do. That physician deserves an award for her dedication to her patients.

In summary the EMR has saved me time, space, and most importantly has improved the care I can provide my patients.