EMR (electronic medical records) in residency..Important or not?

[not4rural]

Just wondering what you guys think of when you interview some places and they don't have EMR...I came from a med school that did it in clinics as well as the hospital...am I spoiled? I've heard some residents complain about having to chart on the computer cause it slows them down, but I think it saves so much time and helps patient care the most.

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[deleted87716]

I EMRs.

I used one in residency, but had to go back to paper charts in practice. Sux.

We're looking at EMRs now, thank God.

I would consider an EMR a definite plus for a residency program.

 

[Faebinder]

Mark my words.... 10 years from now... we all will be using full electronic medical records... the government is dead serious on this... It's part of their vision to head to universal health coverage.

Of course primary care is not harmed by universal health coverage... it's the specialists.

 

[not4rural]

So do you think that programs that don't have it are not preparing residents for the future? I hate seeing a big-fat chart with chicken scratch written all over....I end up spending more time trying to decipher what that word says rather than focusing on patient care....should I write off a program for no EMR?

 

[Faebinder]

So do you think that programs that don't have it are not preparing residents for the future? I hate seeing a big-fat chart with chicken scratch written all over....I end up spending more time trying to decipher what that word says rather than focusing on patient care....should I write off a program for no EMR?

No because it's a learning process that has nothing to do with the residency... in all honesty.... just because you know a system on the computer doesnt mean you know all systems and therefore you will never be prepared to what the government will finally enforce.

Further, many jobs do not use EMR and therefore you will need to downgrade yourself to paper if you are used to EMR.

When choosing a residency, I believe your #1 criteria should be Opposed vs Unopposed... give preference to unopposed programs...

 

[deleted87716]

So do you think that programs that don't have it are not preparing residents for the future?

Personally, yes. However, as of 2000, only a minority of residency programs were using an EMR. I have been unable to locate more recent data.

An Analysis of Trends, Perceptions, and Use Patterns of Electronic Medical Records Among US Family Practice Residency Programs
James G. Lenhart, MD; Karen Honess; Deborah Covington, DrPH; Kevin E. Johnson, MD

Background and Objectives: This study intended to quantify electronic medical record (EMR) use in family practice residencies, associate program characteristics with EMR use, and identify perceptions and issues about the use of EMRs.

Methods: A survey was mailed to all 454 US family practice residency programs, with a 72% response rate. The survey, which was pretested and revised, was designed to identify benefits, problems, perceptions, and trends regarding the use of EMRs.

Results: Fifty-five of 329 programs (17%) were using an EMR, while 10 (3%) had used an EMR but discontinued. Programs in the South reported the highest EMR use (21%, 21/99), and those in the North Central region reported the lowest use (11%, 11/102). EMR use was highest in university settings (19%, 15/81), programs offering fellowships (26%, 24/92), new programs (36%, 18/48), and programs that require research (22%, 20/91). Of the 329 programs that responded, 43% (143 programs) reported having information systems (IS) committees. Of the 55 programs currently using EMRs, 78% had at least one full-time equivalent IS technician. Of programs that discontinued use, software inadequacy was the most frequently cited reason (40%, 4/10). Programs that had never used EMR systems (n=264) were more likely than those that had used EMRs (n=65) to favorably perceive EMRs with respect to 1) meeting program requirements (44% versus 34%), 2) documenting improved patient care (65% versus 43%), 3) providing a reliable research database (94% versus 55%), and 4) documenting resident experience (92% versus 53%). Of the 264 (80%) programs that had never used an EMR, 172 (65%) plan to implement one.

Conclusions: EMR use is low among US family practice residency programs, but some success in implementation of EMRs has been achieved. Based on the responses to this survey, use will likely increase from 55 of 329 programs (17%) to 153 of 329 (47%) by 2000.

Medical Informatics
(Fam Med 2000;32(2):109-14.)

 

[lateness]

Further, many jobs do not use EMR and therefore you will need to downgrade yourself to paper if you are used to EMR.
..

that's true, never really thought about that,

 

[not4rural]

that's true, never really thought about that,

I didn't realize how many programs didn't use EMR...that makes me feel better about the programs I want to rank highly.

 

[hmmminterest]

which programs have EMR? thanks!!

 

[not4rural]

which programs have EMR? thanks!!

Most of the academic programs I've interviewed at. If you are interested in any in Houston, there is a program that is VERY tech saavy...

 

[YouDontKnowJack]

Most of the academic programs I've interviewed at. If you are interested in any in Houston, there is a program that is VERY tech saavy...

I love tech stuff. all these old docs don't want to move up to the computer age.

 

[lowbudget]

I can't imagine a world without EMR. No more handwriting problems, no more running around looking for charts. When we take after-hours clinic calls, we have remote access. When patients get admitted from the clinic, the inpatient team can pull up everything.

You can data mine when your last A1c was, have reminders on when your colonoscopy is due. You can look back at ALL the medications a patient has been on and when and why it was discontinued because each change is linked to the encounter. Freakin' awesome. On rotations where we go to clinics with paper charts, you're basically winging it. Some clinics have the nurses go through the chart while the patient is waiting for you and fill out when the last mammo was, but it's very labor intensive. It's not realistic to think everyone will be EMR when I get out, but I sure hope so. I don't know if it makes me faster. But it helps me make better decisions, especially when I'm seeing an established patient for the first time.

 

[justwondering]

if ure good with computers, i dont think a lack of emr at ur program will be a serious disadvantage for ur future career. if they have emr, u will probably still have to learn to use a new program if u change hospitals/clinics to start working after residency.

there are some really good programs with lots of good learning that do not have emr. i wouldnt exclude them because of the emr issue unless u think u really need practice.

i think emr is awesome and i would love to be at a program where they have it, but if they dont, thats ok. i do always ask abt it at my interviews because it IS one factor.

also, i wonder if using emr in residency can be a disadvantage if u have to work somewhere that doesnt have emr in the future (often emr programs remind u of important tests due, drug interactions, etc....so u'd be less used to remembering them urself....?)

 

[deleted87716]

also, i wonder if using emr in residency can be a disadvantage if u have to work somewhere that doesnt have emr in the future (often emr programs remind u of important tests due, drug interactions, etc....so u'd be less used to remembering them urself....?)

i wuz goin 2 answer ur Q, but the way u type is just 2 annoying, so i chgd my mind.

Kidding... (about not answering, that is.)

I used an EMR in residency, and had to go back to paper charts in practice. No big deal, although I much preferred the EMR. For drug interaction checking, I use Epocrates on my Palm.