My name's Robert DeLuca. I'm an osteopathic family physician.
I practice in a small town out in West Texas called Eastland.
I've been out there about 25 years now.
I presently have my own clinic.
In this town, about 5,000, we service an area
of about 25,000 to our practice
and we have a hospital there across the street.
It's a critical-care access hospital now
because of our location and I have about four other physicians
that help me cover the hospital and the emergency room.
Because it's always a little scary, I think, to physicians,
to think "How can I implement this
and still see patients and get to who I need to?"
You can do that by integrating those together.
If you're still on paper charts, then the way to do that is
to keep your paper charts going while you integrate
the EMR system in, a few at a time, during the day,
until you're comfortable with that, because of
the intensive amount of time it takes to input all the data.
So when you're starting an EMR on a patient,
it's like starting brand-new; you have to put in
all their history and their allergies -- if this
is going to be effective -- their immunizations,
and, of course, all of the demographic data.
In our case, it's going to be easy
because our demographic data is on our billing computer
and that billing computer and our new EMR computer
are compatible, so all that's going to come over.
There are several reasons. I mean, to me, and the best --
For me to go back 12 years ago and say "Why did I do it?"
Well, it's because I have terrible penmanship
and the system allowed me
to produce a note that I was proud of.
When I could print my note off and send it to a specialist
who was seeing one of my patients
or if I had to give it to an insurance company
who was looking at that or whoever else needed
to look at that system, they could read
what I wrote down; it was complete.
It told my patients' past history,
their surgical history; it told their social history.
It said what the list of their problems were.
And I'm hoping, in the future, that my new system will expand
upon that even greater, that's (1).
(2) I think we give better care to our patients.
Now, I don't have to go home at night and think
"Who was that that I forgot today?
What patient did I do such-and-such on?",
so I have to rely on my staff to remember
who it was I saw that I did this to.
I don't have to do that anymore.
A good system will provide those tasks for you.
So a patient that comes in and it's been two years
since I've seen them and I said,
"What have you been doing with your diabetes?"
"Oh, Doc, I just forgot. I hadn't been in.
I've been too busy." Well, they need reminders.
Everybody has an email or they have a texting account
and being able to send patients this information
for them to be able to look into their own charts now, by access,
portable access, and, say, you know,
they want to remember when the last time.
It makes patients more responsible
for what they're doing and gives them
a part of the care with what we're doing.
It is a little scary for physicians to feel
that their back is going to be to the patient
and that they're going to spend so much time on the keyboard,
rather than interacting with their patient.
But it's like anything else,
you begin to learn how to integrate that.
Instead of writing notes or dictating to a machine
or spending the time later, I still am able to go in,
open up the screen, look and see what's going on,
review their history quickly, and then turn
and just have my normal conversations.
We've been doing this so long, all of my patients are used to
having the computers in the room,
so they're not, like, afraid of what's going on.
Spend your time and then be able to get back onto the computer
and finish the note up while you're talking to them.
First of all, I think the most important thing is
making sure they have support, that whoever they go with
should be a company that they feel that
they have personal contact with those IT people.
Because, as physicians, me, personally, I mean, I have
no knowledge of how to program anything or where I'm going.
Find a company that you have that one-on-one with
the question-and-answer people, so that, when you have
a question at that moment, you can get to it
or you're able to get a response fairly quickly.
I think that's (1).
I think there's multiple good systems out there.
Find the one that you feel
the most comfortable, the way it flows.
How does that look? How do you like that screen?
What are you trying to do in your practice, you know?
Are you a dermatologist or are you a family physician?
We need a fairly broad, encompassing program
because we do lots of different things and so
I want it to be able to fit that and make my day flow.
I'm a rural physician. I also have hospital patients
and nursing-home patients and I plan to use the laptop
when I go to the nursing home now, to be able
to coordinate that care a little bit better.
I have home health agencies, so coordinating
the oversight care with my home health agencies
and being able to load all that in to the computer.
So that way, (1) it kind of helps your billing
and it keeps things concise and it documents
what you're doing with each of the patients.