Electronic health records provide doctors with valuable decision support and help them practice far more efficiently, says Peggy Latare, M.D., chief of family medicine for Hawaii Permanente Medical Group. But getting started is far from easy, she acknowledges. Latare, who practices at the six-physician Kailua (Hawaii) Clinic, says the clinic hired temporary physician help in the first weeks of using EHRs because of the amount of time needed for training. "But within a month, I could see the same number of patients as I did before." Entering data, including patients' medical histories, into a record is time-consuming but pays off in the long run, she stresses. "You can make up that lost time in spades because you can take care of patients more efficiently." For example, the records system reminds Latare to check whether certain asthmatic patients have been prescribed an inhaled steroid as recommended in a protocol. Also, the system reminds her that if she's ordering an antibiotic for a woman with bronchitis who is taking birth control pills, she should choose a drug that won't make the birth control medication less effective. Before electronic records, "If you couldn't find blood count results, you might just order another test. Now, I can not only find the result, but if I order a test and don't notice that one's already been done, the system will remind me." When visiting with patients, Latare uses the EHR to easily share information to help influence their behavior. "I can graph someone's weight progress with a few clicks and put together a chart for the patient," she says. "That can start a conversation about why they think their weight has gone up." And the EHR makes it easy for Kaiser hospitals and physicians to share information. That's particularly important in Hawaii, where Kaiser has 400 physicians on three islands. "There are a lot of times when several of us are on the chart at the same time." Latare saw first-hand the power of electronic records when a member of her staff was seeing a Kaiser physician to prepare for elective surgery. The EHR alerted the surgeon that the patient was overdue for a mammogram. The surgeon immediately ordered the test, which revealed the patient was in the early stages of breast cancer. Treatment was effective. This article can also be found at HealthDataManagement.com.

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