S04 E02: Electronic Medical Records

In this episode of TeamUP! we have a quick teamBIT in our tech for teams season, this one is on Electronic Medical Records.

I jump into thinking about how to use the EMR for decision support and recalls and admit that we have to start with improving data quality and encourage teams to think about promoting someone on the team to a role of data quality improver or recaller.

As always - please send us feedback by email [e-mail] - now is a great time to suggest future topics or pose questions.

What is Team Up! Team-based primary and community care in action?

A podcast that brings together primary care providers, healthcare planners, patients, innovators and others to talk about the changes that are happening in primary care in British Columbia.

Morgan: Are you working in a primary
care team and wanting to use your

electronic medical record better?

Yeah, me too.

​

So, EMRs or electronic medical
records can be the single source for

patient information for a whole team.

The E M R can be accessed and
updated by all members of the

team no matter where they are.

And when this happens, the EMR
can improve communication and

coordination across the team.

And we've talked about this before in
the podcast, a good EMR that everyone

can access, reduces the risk of errors,
can reduce the risk of duplicate

tests and things like that as well.

There's lots of things to think about
when using an electronic record as part

of a, primary care team, particularly
when you have different roles,

different professions that are working.

, and I think that that's an important
thing to think about as a group.

What are some of the norms you wanna
bring into your records so you know

what you're talking about and other
people know what you are talking about.

One of the big challenges with
electronic records is that we don't

always reach the potential of using
the E M R beyond an electronic paper.

And part of the reason for that,
and a large part of the reason for

that is that we need to make sure
we have better data in our system.

So that old expression of garbage in
garbage out is totally true if we're

not using the EMR to put in the right
kinds of data that we want to then

use to turn that into information.

It doesn't work as well.

We can still read it as an electronic
paper record, but we can't use it

for things like clinical decision
support, recall lists, and that sort

of chronic disease management In a
way that really are some of the key

benefits to having an electronic record.

The good thing about having a team is
that you can, and you probably will have

somebody in the group that has a special
interest, and it may be the coach, but

it may be one of the clinicians as well.

could be one of the office assistants.

But what you want to do is find that
person who's got a keen interest and

elevate them so that they can be the
quality improver of the E M R, and they

can look at and understand a little bit
better what some of the options are.

How to better code for those things
that are important for you, and

then encourage the team to do that.

Is diabetes important for you?

It's less so in my practice.

In our practice, things like h I v,
Hep C have been really important and

so we've worked hard on bringing our
data quality up in those areas and it's

made a huge difference for recalls,
for treatment and it's been, just

from a quality perspective, it's been
massive, but it's taken some effort.

And so having somebody in the team
who's got that capacity and interest, it

doesn't have to always be the same person,
but that that is a way to engage in.

That improvement and then start
to tie that to the, the clinical

quality improvement in a team.

You can also have a recaller, somebody,
uh, that is focused on bringing

people in or making sure people
are getting the right follow up.

And once you have the better
data, then you can use the

EMR in these different ways.

So to think about the E M R and
how we can use that technology

better in our practice, sadly, the
first thing is always data quality.

And data quality is everybody's business.

and we need to think about
this in our day-to-day.

Every little bit helps.

So as you're going through
your day-to-day, if you're a

clinician and primary care,
Think about one patient today.

Clean up their problem list
or clean up their med list.

Do something like that.

And if everybody does that once
a day, you're gonna start to see

that improvement in the data.

And then define that
quality improver role.

See who wants to do that, and they
can start looking at some of the

areas that you want to focus on.

And that can be your coach and
that can be a person in the

clinic working with your coach.

Take a meaningful little project.

Pick one that uses the EMR data.

So the work you're doing is valuable.

And then don't be discouraged.

you do need to do that
data quality cleanup.

It's just, that's the hardest part about.

You know, having used an EMR
for years and then trying to do

something with the data that's there.

So if you do have that quality improver
role, then you do have a real reason to

start to clean up the data and you'll
start to see how the E M R can help you.

And I think that's really
important as a team.

So there we go.

There's our first team
bit on tech for teams.

Just a little reflection on electronic
records and, sorry, it kind of starts

with data quality, but, um, that is
kind of foundational and, and you're

gonna be able to build from there.