The Institute of Medicine (IOM) estimates that approximately 1.5 million medical errors occur annually. Both the IOM and Congress have endorsed the use of EMRs as a key method in the prevention of medical errors through better access to medical records and prescribing errors caused by the inability to access medical records readily at the point of care.

As Congress has provided hospitals with incentives to move forward with adoption of electronic medical record systems, adoption in maintenance of inpatient records has increased. Although the same incentives are not available for individual outpatient practices, use of these systems by physicians' offices to improve workflow and access to medical records also has increased.

PREPARING FOR THE EMR

The locum tenens provider can remove many obstacles in understanding the functions of the EMR by making early contact with the practice manager or hospital medical records department before traveling to the site. This allows the provider to understand the type of system in use for inpatient and outpatient medical record keeping, and it allows the provider to prepare a list of contacts who can assist on-site with training or technical problems encountered with the EMR. Many hospitals also offer online training for their specific system, allowing users to familiarize themselves before assignment.

Every EMR requires the user to access medical records with a secured password. Early contact with site managers will expedite the user access and password process, as well.

Finally, identification of the type of EMR in place and understanding its utilization in practice may also be helpful. Once the EMR type and manufacturer are identified, the provider can use Web-based tutorials from the manufacturer or site to become familiar with the use of the EMR.

Usually, site-based tutorials will be more helpful in that healthcare organizations may use the same EMR with differing deployments specific to the institution. For instance, as e-prescribing allows hospitals and providers access to additional reimbursement for its use, access to these features within the EMR has increased.

Given the financial benefits for institutions, the adoption of e-prescribing is likely to increase both within healthcare systems and in private offices. Thus, an understanding of how the provider functions within the confines of the EMR is important in ensuring efficient office flow and decreasing anxiety concerning the use of an unfamiliar system.

More information concerning these systems in advance of the assignment and identification of key support personnel can alleviate concerns regarding EMR use in clinical practice.

ACCESSING THE EMR

While on assignment, the provider may need access to the EMR from a remote location. In these cases, most institutions have provided secured networking interfaces for allowing remote access to the institutional EMR.

This is useful when the outpatient facility and the inpatient facility are remote from one another. As a provider of maternal fetal medicine, I often need to review fetal monitoring strips that are ongoing at the inpatient facility while maintaining a lively office schedule filled with ultrasound, genetic consults, and maternal consultations.

In these situations, I find that access to the remote EMR allows me to complete many tasks from the office without travel and thus without interruption of the clinical office productivity. Another benefit of remote access is the ability to edit, complete, and sign billing forms and dictations. This can be especially helpful for completion of charts that are not available before the end of assignment.

By taking advantage of these services, hospitals and on-site providers recognize the dedication of the locum tenens provider's services and the attention to detail in record completion. This is an excellent manner to ensure that your services are recognized as proficient and professional.

FINAL THOUGHTS ON THE EMR

As we move into the next generation of healthcare delivery, the EMR will become an increasingly important tool in the delivery of healthcare. With financial incentives for both healthcare organizations and independent practitioners to adopt electronic medical records, these systems will become increasingly common.

Despite the seemingly complex nature of EMR systems, planning for their use before assignment will increase productivity and diminish the stress and anxiety surrounding them.

WEB SITES OF INTEREST

EMR

• McKesson, http://www.mckesson.com/
• Practice Partner, http://www.practicepartner.com/
• eClinicalWorks, http://www.eclinicalworks.com/
• Iasis, http://www.iasisnet.org/