Ending the Paper Chase
Doctors find computerized cure for records dilemma
Boston Sunday Globe By Madeline B. Gaughran – Globe Correspondent
February 16, 2003

Cohasset – Something is odd in this doctor’s office.

The waiting room is conventional, with plenty of magazines to read. The receptionist and nurses are friendly and busy. But the exam rooms are all outfitted with computers and there are no plastic holders on the door for patients’ charts. In fact, there aren’t any charts. Aside from a box of business cards and some forms for new patients, there isn’t any paper to be seen.

South Shore Orthopedic Associates is on the edge of what many say will one day be standard practice in medical offices nationwide. It uses electronic medical records, or EMRs. Every encounter with every patient, every prescription issued, every signed consent form is logged, collected and stored electronically.

Recent federal legislation requiring doctors to safeguard the confidentiality of patient records is slowly motivating doctors to abandon the paper trails and replace them with EMRs. Unlike paper charts, EMR software can prevent unauthorized staff from accessing patient information, and it can record who has accessed or entered patient data. EMRs can be accessed from satellite offices, hospitals, or doctor’s homes.

Bill Munier, president of Wang Healthcare Information Systems Inc., which developed the software used in the South Shore Orthopedics’ Cohasset office, cites the technology of information systems as one of the most significant developments in medical care today.

It may not be gene therapy, said Munier, but “this affects every patient with every diagnosis.”

The software, called Physicians’ Workstation, evolved from a Department of Defense contract with Wang about 10 years ago, Munier said. Wang implemented the system for the Air Force. Military physicians needed to access soldiers’ medical records from different bases and remote locations.

Ideally, EMRs will allow doctors and other medical staff to spend more time with patients and less time with paper work. Some area doctors say they see 15 to 60 patients each day.

But the initial investment is significant, according to Marcia Peterson, a partner at SOS Center, Inc., an application service provider. SOS has introduced EMRs at several area offices. The software and process of converting an office to it can cost $10,000 to $15,000 per doctor, and it can take a long time to scan or transcribe charts onto the new database, according to Peterson.

For example, Scituate Pediatrics – which began converting to the system last summer – new computer monitors were needed to accommodate the Wang program, hardware had to be upgraded, software had to be installed, and the staff (including four doctors and four nurse practitioners) had to be trained.

The Scituate office, led by Dr. David Morin, is serving as the pilot project for Physician Strategies, a physicians’ service organization for 35 area doctors. (Morin is medical director for Physician Strategies.)

It will take another year to fully convert Scituate’s office, which has over 10,000 patients, said Jack Bradbury, CEO of Physician Strategies.

This group may not see a return on its investment for a few years, but already patients are benefiting, Bradbury said. “We see our return when a patient goes to a satellite (office) and has his whole chart brought up on the computer,” he said.

“There is a time investment, especially for the doctors,” said Gail McKenna, office manager for South Shore Orthopedics. “But now we can’t image us without it. You can just spend more time servicing the patient and less time worrying about the chart.”

Before, we were always looking for something” said Kathy Abruzese, a registered nurse who years ago began her career as a self-described “paper queen,” filing medical records. “It was a pain in the neck carrying around 40 charts or so all the time,” she said. “Now everything is right in front of you.”

Many people who work in the medical industry say doctors in private practice are change-phobic. Despite the apparent advantages, EMRs are still rarely seen in local practices.

“Physicians don’t transition well. They got beepers, but they seemed to stop there,” said Bradbury of Physician Strategies. Younger doctors may be easier to convince.

At South Shore Orthopedic, Dr. Glen Seidman, 39, is pleased with the conversion.

“It makes us a faster and more advanced organization,” Seidman said. “It serves both the patient and the physicians with ready access as well as protecting privacy. It is the trend for the future for most if not all doctors’ offices. I’m very interested in using it and I don’t want to be left behind.”

Copyright 2003
The Boston Globe
February 16, 2003