 Many
docs long ago leapt upon the information highway, set
up their own websites and won't be caught dead without
their PDAs, but there remains a strong contingent of dyed-in-the-wool
Luddites who insist that there's just no replacement for
the written word.
Just 3% of your colleagues use
electronic-only means of storing patient records. Others
(24%) rely on a combination of electronic and paper
media, but according to the latest available stats,
the Canadian Medical Association's 2002 Physician Resource
Questionnaire, an astounding 69% still opt for the good
old-fashioned paper and pen. Here's a tale of two doctors
-- one low and the other high tech.
MAN
NOT MOUSE
At first glance, nothing seems out of the ordinary when
you step into FP Dr Ngon Dien Vu's Montreal office.
In the waiting room, a row of standard doctor's office
chairs lines the wall and the usual array of last year's
Chatelaine and Maclean's magazines overflow
on a table in the corner. At the nearby reception desk,
his medical assistant is busily fielding calls and pulling
patient charts from a sturdy filing cabinet.
But when you pass through to Dr
Vu's dimly lit office, it's like going back in time
-- where is that blue glow that emanates from everyone's
desk these days? By Jove, there isn't a computer in
sight. "I'm a low-tech person," says Dr Vu proudly.
"I write everything by hand and keep hard copies of
patient records. I'm not the young generation and I
won't be using computers any time soon." Come to think
of it, his assistant's desk was also devoid of post-1980s
technology -- but it did boast a very large paper trail.
No need to ask when they'll be switching over to electronic
health records.
MIGHTIER
THAN THE PEN
Meanwhile, over on the West Coast, a very different
sort of ground is being stood. Dr Alan Brookstone's
family practice in Richmond, BC is about as far as you
can get from Dr Vu's experience -- he can't get enough
computer action. Dr Brookstone is so tech savvy that
he even offers consultation on integrating technology
into clinical practice settings. "In Richmond, I'm putting
a group of doctors together who communicate via email
about various computer technologies that can help them
in their practices," he says.
But he can see how docs like Dr
Vu could resist. "The main issue right now is that computers
don't fit into the natural workflow of physicians,"
he admits. "The tools need to be much more user friendly."
And when it comes to government support for those of
you who want to computerize your office, don't hold
your breath. "Alberta and Ontario are the leading provinces
when it comes to financial support, but only these two,"
says Dr Brookstone.
Dr Brookstone is an enthusiastic
advocate of electronic medical records (EMR), so much
so that he's created a website called CanadianEMR to
help his colleagues learn about EMR systems in their
province and how to select the right system for their
specific needs. But he admits there are drawbacks: "If
you're examining a patient and you have to input information
into a keyboard, it can take too much time and take
away from the doctor-patient relationship."
He also leads the yearly Technology
in Medical Practice conference for physicians and speaks
at a number of medical conferences, hospital events
and health technology events. Some of the topics include:
how to select and implement the right electronic medical
record system, how to use the web to enhance patient
care and the implementation of computers and handheld
devices at the doctor's office, among others.
For more on Dr Brookstone's
website, Canadian EMR, please visit http://emruser.typepad.com
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