Medical Records Case Study Section I (Introduction)

Medical Records Case Study

Section I (Introduction) -- Liam O'Neill and William Klepack, the authors of Case Study # 3, Integrating Electronic Medical Records and Disease Management at Dryden Family Medicine, begin their published findings by introducing readers to the concept of electronic medical records (EMR). The authors immediately narrow their focus to the adoption and implementation of EMR by Dryden Family Medicine, a rural family practice located in upstate New York, and explain that "for smaller group practices, electronic medical records (EMR) adoption is a huge undertaking that poses significant risks" (O'Neill and Kleback, 2010). The Introduction section then covers the multitude of obstacles encountered by small group practices attempting to convert to EMR, including the limited information technology experience possessed by most staff members, and the constant concern of budgetary constraints. Finally, the authors seek to clarify the emphasis of their study by stating that their focus remains on the journey of EMR implementation, and not the eventual results.

Section II (Background) -- This section of the case study provides readers with a comprehensive overview of Dryden Family Medicine. Beginning with the practice's founding by John Ferger, MD in 1955, the Background section covers more than four decades of history. One of the more interesting facts presented in this section concerns the practice's continual growth, culminating with the observation that, by the year 2004, "DFM had grown significantly to encompass a patient panel of more than 7,000 and provided more than 12,000 patient visits annually" (O'Neill and Kleback, 2010). The section concludes by reviewing the evolution of Dryden's medical record keeping, starting with the 4 x 6 index cards originally used by the practice in 1955 and covering the various industry changes which necessitated a transition to EMR techniques.

Section III (The Vendor Selection Process) -- This section covers the process employed by Dryden Family Medicine to direct the transition to EMR. The authors begin with the steering committee established in 2002, which was "composed of one physician, the office manager, the nursing supervisor, and the front-desk supervisor" (O'Neill and Kleback, 2010). The issue of vendor fallibility is explored, as the choice of an unprepared or unskilled billing systems provider could easily undermine the practice's 50 years of record keeping. Finally, the reader is guided through the EMR vendor selection process, from the industry trade journals to consultations with fellow family practices that have previously implemented EMR systems.