Navigating a New EMR
EMRs suck. And there are a lot of them. When you start at a new clinic, the EMR is often the most immediate obstacle to your efficiency. However, you can probably ignore most of the bells and whistles. Mostly, you just need to know how to get in and out of a note without losing your mind.
Over the course of my locums assignments, I had to become acclimated with Practice Fusion and ModMed EMA (I already had working experience with Epic). If you’re nervous about learning a new system, here is the framework I used to get up to speed in about 20 minutes:
1. Where is your actual clinic schedule? This sounds obvious, but every EMR hides it differently. Make sure you can see the schedule for the right day and the right location. I used it to verify that patients were scheduled on the correct days, at the agreed-upon clinic location, and at the agreed-upon intervals. You can also ensure there are no surprises (i.e. peds derm patients if you are not comfortable with that cohort or did not agree to see them).
2. Who does what in the software?
Clarify exactly what the staff handles versus what you are expected to do in the software. This directly ties into clinical workflow as well:
Will you have a scribe? If so, will it be an MA scribe or an AI scribe?
Will your MA pend prescriptions to be sent?
3. How do you finalize and amend notes? Another self-evident point, but one that can be surprisingly and frustratingly complicated. Make sure you understand the process for signing and closing a note. You should also know how to create an addendum for a signed note if needed. If relevant, find where "dot phrases" or "templates" are stored to reduce repetitive typing.
4. How do you access prior pathology and outside records?
This is another essential point that can be surprisingly difficult to find in an unfamiliar system. Locate the results tab or media section early so you aren't hunting for it while a patient is in the room.
5. What is the workflow for results follow-up?
Take some time to determine the following:
Where new pathology results appear for your review.
Who is responsible for notifying patients of benign versus malignant results.
How to "clear" or "archive" a result once the appropriate action has been taken.
I think that efficiency in a dermatology clinic with an unfamiliar EMR comes from mastering the workflow, not the software. If possible, play with the EMR’s sandbox or try to have the lead MA or other office staff member walk you through these basic points before you start your first day.
