Entering data into electronic medical charts

One of the biggest decisions to make when switching to electronic medical charts is how you will enter patient data. There are two aspects to this question: what method you’ll use to enter information, and what equipment you’ll enter it on. Popular data entry methods include:

• Keyboard and mouse combinations – some doctors may be comfortable typing notes, while less technology-inclined physicians may prefer to select from lists of exam codes and diagnoses to update the electronic medical charts.
• Touch screen applications are very quick to use for standard procedures and codes, but can be very inefficient when the information you want to enter doesn’t fit the template neatly.
• Speech recognition is very fast, but some doctors may not be comfortable with dictating notes while the patient is in the room. (Keep in mind that you may also want to simply record doctors’ notes for later transcription.)
• Handwriting recognition lets doctors continue to work in a familiar style, but can balk at the messiest handwriting.

Hardware options for electronic medical charts include several different sized computers:

• You can install desktop computers in each exam room, or purchase laptop computers for each physician. This may increase your initial expense, but it can reduce the time doctors spend entering information. They’re also familiar to many users and can be used for more than just electronic medical charts.
• Tablet PCs are specialized, clipboard-shaped touch screen computers designed specifically for electronic medical chart applications. Doctors can easily use them while meeting with patients.
• PDAs are even smaller than tablets. They can be cheaper and more portable, but may be less efficient to operate than full-size computers or tablet PCs.

One of the best ways to proceed is to choose an electronic medical chart system that supports multiple data entry methods. This lets you start with one method and later switch to another, or support multiple modes for different doctors.

Whichever method you choose, be prepared for a slowdown in productivity when you first implement the new system. Once users get used to the electronic medical charts, productivity will gradually increase.