Morrow J 2004 "Davies Recognition Program: independent primary care practices - North Fulton Family Medicine."

"A Problem Oriented Case Management-Patient Face Sheet screen organizes longitudinal summaries with detailed drill-down capability on all patient problems, history, encounters, medications, orders and procedures. Chart by exception enables providers to apply the last encounter's information to the current visit as a template and proceed to chart by exception. Through the solution, the practice also can customize a variety of 'chart by exception' templates to match individual physician methodologies, including tracking multiple reasons for a visit, reviewing systems and medical history as well as reviewing physical exam, assessment and plan."

"With the EMR, North Fulton physicians complete SOAP notes while in the exam room with the patient by simply pointing and clicking through the exam. Since [the] EMR is knowledge-manager driven, much like templates, when you check a chief complaint, it then drives the process. However, unlike most template driven systems, North Fulton physicians are not stuck in that process and are instead able to jump back and forth ... While documenting the entire progress note, the system also creates a quick note of the complaint, the assessment, the plan and the medications prescribed. It stores these in the electronic record so it can be accessed easily."

"Electronic prescriptions can be managed via fax and e-mail directly from the chart, greatly reducing chart handling and refill turn-around times. Physicians are able to track prescription refill frequency. Medication interaction and allergy alerts prompt physicians to consider the effects of certain drug combinations, increasing patient safety."

"Part of this retention success is credited to better employee communication. The practice no longer must draft and make 60 copies of memos regarding hours, changes, etc., and they no longer need an employee communication board, both of which were relatively ineffective. Now, they simply draft an email and distribute it internally."

"The practice has taken advantage of [the] EMR's customizable features, which allow the practice to design workflow based on its preferences ... It manages orders, procedures, prescriptions, lab results and other data previously collated into patient charts by hand onto paper."

"The [EMR] enables practices to maintain problem and medication lists; generate preventative care reminders; receive medication interaction, allergy or lab abnormality alerts; and harvest patient information to generate population-based reports. Faxes can be sent directly from the EMR and inbound faxes and scanned documents are easily saved as digital files in patient charts. These functions not only save time and cost, but more importantly allow the physicians to spot and resolve immediate or potential problems."

"Prescriptions, referrals and orders are generated automatically, again reducing hassles for the patient ... Customizable referrals, back-to-work and back-to-school letters are generated from chart notes and patient education sheets can be customized. Each of these documents can be printed importantly, the EMR improves patient safety by allowing doctors instantly to check potential drug interactions and receive lab results."

"Physicians are able to log on from home via secure high-speed Internet for decision support while on-call as well as to manage the practice while out of the office."

"The EMR has increased the completeness of patient charts, due in part to the setting of mandatory fields, and facilitates more complete documentation by the physician."

"By using [the] EMR, North Fulton has eliminated all transcription costs and processes, and has prevented lost or misplaced charts."

"Microsoft Outlook integration facilitates better communication within the practice and between the practice, hospitals and specialists via secure two-way sharing of patient chart information; items in the chart can be sent to hospitals, specialists or referring doctors and received items can be added into the chart as attachments. The e-mail communication system also enables instantaneous sharing of chart information throughout the practice and speeds prescription refills."

A software add-on "facilitates patient-provider e-mail communication, which can be logged directly into the patient chart."

The integrated practice management system "improves the productivity of administrative staff, simplifies patient record keeping, streamlines billing, improves cash flow, increases the practice's capability to expand, and more."

"A paper encounter form is the only hard-copy document the practice still uses. From there, the electronic system notifies nurses among other things to bring patients to their exam rooms and triage, to complete a medical history, and to process refills when needed."

"The practice drastically has decreased the amount of time it spends on administrative functions." "The reduced paperwork and streamlined workflow allows nurses and doctors to leave at 5:30 p.m. Previously, it was commonplace for physicians and support staff to be in the office until 6:00 or 6:30 p.m. finishing paperwork and returning calls for prescription refills, which drive primary care practice. What used to take up to five minutes now takes only seconds."

"The upgraded telephone system created an automated lab system ... where patients can call in to get their results, an appointment reminder ... and the addition of a triage nurse to streamline patient communication, further freeing nurse and administrative time. Prior to telephone upgrade, North Fulton handled approximately 38,000 calls per month. Now, North Fulton has reduced its call load by 12,000, freeing nurse, physician and staff time."

"With instant access to medical history information, patients can securely enter their medical history and reason for visit securely from the Web or waiting room. Patients provide the reason for the visit and complete a customized template questionnaire designed by North Fulton. The data then is fed directly into the EMR, enabling physicians at North Fulton to have 10 percent of documentation completed before the patient even enters the exam room. Physicians then review and confirm information."