The topic of this week’s discussion is related to the integration of electronic medical record (EMR) systems at RURAL family practice settings. Such settings increase the challenges of implementation mostly due to resource limitations. Typically, smaller practices suffer from lack of in-house information technology support and limited IT budgets. In this scenario we will discuss how small organizations can successfully implement EMRs, enhance their core mission of delivering quality care, and minimize security and patient health risks.
The family practice we are investigating has been established in the New Tampa area in 1990*. Currently it employs 3 physicians, one nurse practitioner, one nurse and two staff assistants. It provides services to more than 1500 patients and last year had 4000 patient visits.
When the practice first opened, each patient’s chart included a double-sided standard sheet of paper created for each visit, test results, images, progress notes, prescribed medication and demographics information. The size of these charts has been increased exponentially since then and in 2009 the practice has decided to move forward with an EMR implementation. The practice has been using an electronic billing and scheduling system for years, however the personnel was skeptical for the EMR implementation since an unsuitable system could destroy the continuity of the patient’s medical record, incur additional costs and disrupt patient care and staff function. A committee comprised of one physician, the nurse and one staff assistant was formed to define the EMR requirements. Unfortunately, the practice did not have a budget for IT support. Luckily, the nurse had training in nursing informatics and became the internal IT consultant. After extensive research, the committee decided to invite two vendors for an onsite demonstration and finally selected one for the