Berman H 2009 "Response to request for information by Heidi Berman, employee of a EMR reseller, on August 24, 2009."

Berman H. Response to request for information (RFI) by Heidi Berman, employee of an EMR reseller, on August 24, 2009. Agency for Healthcare Research and Quality; 2009.
"Heidi Berman was 'the office manager of a small, two-physician practice who eventually went to work for an EMR reseller. [She] did this because [her practice's] implementation and training was so poor that [she] felt the vendor would fail and [her practice] would be left without support. [She is] reporting her impressions and opinions based on these dual roles.'"

To provide the impressions and opinions of the former office manager of a small practice who went to work for an EMR reseller.

Type Clinic
Primary care
Type Specific
Internal medicine
Small and/or medium
Other Information
The internal medicine physician had 7,065 patient visits each year and the surgeon had 5,300 visits.
Type of Health IT
Electronic medical records (EMR)
Context or other IT in place
Other IT in place included electronic prescribing, integrated practice management, and billing software.
Workflow-Related Findings
"Everyone had to relearn cues. We learned to look at the computer screen to recognize where patients were in the encounter process."
"I am far better able to track our inefficiencies with the EMR ... I am better able to track medication refills, whether lab results have been reported to the patient, whether patient phone calls have been answered in a timely manner."
"Staff no longer spends time hunting for charts, lab results, letters, reports, etc. All is funneled through one person, who easily manages scanning."
"Using the registry function, I am able to isolate groups to send them specific information or reminders, such as flu shots. Prior to the EMR, such services were hit or miss."
"The providers, however, feel that it takes much longer to complete a patient transaction. I think that this is because more tasks are completed in one sitting (lab ordering, prescriptions written, informational material generated, coding). In the past, these tasks were often accomplished with a verbal order to a staff member and the progress note itself was sent for transcription."
"[The physicians] agree, however, that they have much more information at their fingertips; this includes patient history, current medications, current lab results, as well as clinical resources- such as Up-to-Date, CDSS, etc."
Study Design