Beeler A 2009 "Response to request for information by Dr. Angela Beeler of South County Pediatrics on July 6, 2009."

Beeler A. Response to request for information (RFI) by Dr. Angela Beeler of South County Pediatrics on July 6, 2009. Agency for Healthcare Research and Quality; 2009.
"Dr. Angela Beeler is the medical director of South County Pediatrics, a part of the Department of Pediatrics at UMass Memorial Health Care. Dr. Beeler gives an account of their clinic's implementation of an EMR and the impact it has had on a variety of their workflows."

To give an account of the implementation of an electronic medical record (EMR) at South County Pediatrics and the impact it has had on their workflows.

Type Clinic
Primary care
Type Specific
Small and/or medium
Type of Health IT
Electronic medical records (EMR)
Type of Health IT Functions
Functionalities of the EMR consisted of electronic health history, immunization and growth tracking; scanned/dictated progress notes; electronic prescribing; scanned paper medical records; electronic tasking (communication between office staff and phone messages from patients); and billing.
Workflow-Related Findings
"The EMR interfaces well with our Health Care system's scheduling and laboratory/diagnostic imaging applications."
"Electronic tasking means that paper notes are no longer lost or misplaced, and I can easily see what is in someone else's "inbox". However if a parent calls about three kids with the same question, then three separate tasks must be created to go in three charts. We do more electronic tasking and less sticky notes or face to face communication."
"Now I must electronically task requests about procedures to be scheduled as well as fill out the pertinent procedure order form. We do not yet have electronic ordering, which theoretically should make care coordination easier."
"Information to/from pharmacies is somewhat better with e-prescribing, but we still make errors that the pharmacy has to call us about."
"Communication from sites outside our own institution still comes paper based and is scanned into the record."
"Putting data into the EMR can be time consuming as you search among the options it allows you for Medical History - you cannot put in free text except as a comment within a diagnosis."
"Our notes are still paper based then scanned in, so that hasn't taken more time."
"I get distracted by the computer during the visit."
"Having access to all the records from our health care system during the visit can make decisions more informed. Also with e-prescribing I have a better idea of what prescriptions might be covered by their insurance ... Access to patient-related information is much easier. I no longer have to search for a chart. Occasionally I have to search for paper that hasn't been scanned in yet."
"I find that an EMR has shifted some of the workflow from secretarial staff to providers. In the old workflow the front desk would take labs off the printer, pull the chart and bring to my desk. Now I just get the lab papers, I have to pull up the chart in the EMR."
"Billing online has been onerous. I used to be able to quickly check off boxes on a paper. Now I have 4 pages with multiple sub-boxes of information I must click through to send a bill. The work of entering billing information has shifted from a secretarial person in the billing office to me."
Study Design
Study Participants
The study participants included South County Pediatrics clinical and administrative staff.