Because the printer is in the hall 2 steps from each exam room, I can do that faster than the nurse can find these documents in our paper system. This is particularly useful if the information on the possible link between isotretinoin and inflammatory bowel disease is missing from our isotretinoin packet.
FIGURE 4
Patient education tab
OneNote can be used as an indexing aid for patient education materials by simply dragging and dropping into it the links to “original” patient education documents. By clicking on this link, one can go to the information that resides elsewhere, and print out the material for the patient.
Many advantages with this new system
With OneNote, I have elements of a mini-electronic record with summary sheets for patients with malignancies, prescription writing, and patient handouts. In addition, I will not lose this system in a corporate buyout or be charged exorbitant fees to transfer records. Tabs can be password protected for security, and all pages under a tab can be saved in Adobe Acrobat, Microsoft Word, and OneNote formats. Those features help assure security and portability. (This system does not, however, qualify users for government incentives, as it lacks certain functions that are available with a true EMR.)
True e-prescribing—which, for me, included entering patient demographics and offered electronic access to my prescribing history for each patient—is usually an intermediary step for those moving toward full EMR implementation. Using OneNote, I carry a laptop/notebook room to room and print a lot of patient information handouts that otherwise would have to be retrieved from elsewhere.
As a trial, I used the OneNote system along with iScribe’s replacement e-prescribing product for several weeks. My OneNote system was faster. Now, only when patients specifically request e-prescriptions do I use the iScribe replacement product, which, after the corporate merger, has been continued at no charge for 2 to 3 years for existing users. (E-prescribing for Medicare patients at least 25 times in 2011 will qualify users for the Medicare incentive bonus.)
Because the “computer” portion of patient encounters usually occurs at the end of the visit, it does not interfere with the patient-physician relationship. Additionally, my average patient has already been “teched” with a digital scale, digital blood pressure cuff, and digital camera, so a computer is probably one of the more familiar pieces in the technoscape.
OneNote has become a powerful ally in my clinical practice. I thought I had everything I needed with Word, Excel, and Acrobat. But I’m glad I opened OneNote out of curiosity. It’s not only helped me to modernize my patient “problem lists, “ but it’s proven to be the solution to my e-prescribing dilemma.
CORRESPONDENCE
Gary N. Fox, MD, Defiance Clinic, 1400 E. 2nd Street, Defiance, OH 43512; foxgary@yahoo.com