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  • February 09 2012

    HIMSS12: Why my patients love my EHR system

    Dr. Christopher Tashjian will be speaking about his ambulatory Meaningful Use attestation experience in the Cerner booth (476) at HIMSS12 on Feb. 22 at 3 p.m. A video of Dr. Tashjian discussing Meaningful Use is available at

    As a family physician in a small rural community, I'm not in the thick of the debates over health information technology. But I know something that policy-makers in Washington need to know – and consumers across the country, as well.

    My patients love their electronic health records (EHRs)! They totally understand how EHRs are improving their care, making it safer and more effective. A year ago, they wouldn't have known to ask if we were using an EHR system. But since our practice implemented them, they see the difference – and they want more.

    The reason my patients' enthusiasm is important outside of Ellsworth, Wisc., is that it can help us all keep our perspective. For example, the Institute of Medicine (IOM) has issued an excellent report, Health IT and Patient Safety. The report says we need new provisions for quickly reporting any safety problems with EHRs as soon as they're discovered, as well as mechanisms for taking action. Of course that's right.

    But let's not misunderstand: electronic health records are already improving the safety and quality of health care. The faster we adopt EHRs in practices and hospitals across America, the better. The care you get will improve immediately when EHRs are properly implemented in your doctor's office, because EHRs enable providers to do things they just cannot do with paper.

    Then, with EHRs increasingly the norm, the technology will keep improving as features such as IOM has recommended get put in place.

    Why do my patients love EHRs?

    For one thing, our EHR system enables us to give each patient a summary of their visit as they walk out the door. That means the patient can genuinely understand what happened and what we recommended: medications, tests, next steps. It means the patient has a clear account to give to other providers, if that's needed. It also means our patients can check to see if they agree with the information on the record, and correct us if we're wrong. That kind of partnership is the essence of good care and safety.

    Our patients also appreciate, just as I do, that our EHR system automatically double-checks as we prescribe medications, making sure there are no potential adverse interactions with other drugs the patient may be taking. And it's a convenience for the patient that my system makes me fill out complete information – such as whether a prescription can be refilled – before the order can be placed. The patient, the pharmacist and I all save time. The information is complete, checked for safety – and even legible.

    With EHRs, our care management can be “active” in a way that is not possible with paper. Instead of waiting passively for the patient to make his or her next visit, we can actively query our EHR system to ask questions like: Whose blood pressure needs more frequent monitoring? Whose cholesterol levels need to be checked? We can even look across our patient population and ask the computer: “How are we doing in achieving high-quality outcomes for specific conditions?”

    Some months ago, when the U.S. Food and Drug Administration (FDA) provided new advice about possible interactions between a widely prescribed cholesterol-lowering drug and a blood pressure medication, we were able to immediately identify the 250 patients who were taking both drugs, contact them, and change the dosage as recommended in the FDA's new advisory. That's a new kind of care – more effective, more personal, and safer.

    In one year with EHRs, we have made more progress toward improved and safer care than we achieved in the previous 20 years with paper. Next year, we can expect to keep improving at the new pace. The possibilities, and the expectations, are being transformed.

    So my patients indeed know something that the rest of the country needs to know. And I believe physicians who have adopted EHRs will say the same. I know many doctors who found the transition challenging and difficult. But I don't know any who would go back to paper.

    Christopher H. Tashjian, MD is the president of River Falls, Ellsworth and Spring Valley Medical Clinics in Wisconsin. The three clinics provide primary care services as well as specialty consults. Dr. Tashjian implemented Cerner's Ambulatory EHR in March of 2010 after several years of working with Cerner's PWPM solution.

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