There are some weird ideas which keep surfacing in this debate, and
[log in to unmask],Net wrote about "RE: paperchase":
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>To maintain an EMR at
>the expense of the conventional record is irresponsible. A 6 foot
long
>fanfold printout is next to useless.
But the same information on small pieces of paper folded and bundled
into a lloyd George envelope is better?
> "The Lloyd George envelope has its limitations but at
>least the information should be in there somewhere. "
Indeed it _should_, and it even _may_ be.
But is it accessible?
Fanfold paper has its limitations, but many of these can be overcome
by cutting it into pages of convenient size, and mounting them in
sequence with the cards, if that is how you want the info presented.
We use A4 and try to print at the same width as FP7 cards. Neater.
One of the recurring themes here of course is that some GPs make too
many notes (hence the complaint about the length of the printout)
I have a patient who arrived from another local practice with a six
foot fanfold printout, which I have found extremely useful. Easy to
read, clear (a System 5 print as it happens, but it could equally
well apply to one of the local Exeter System users) and easy enough
to handle.
An Abies practice locally printed out the whole narrative from a
patiet's record, on A4 and bound it into their A4 hospital notes.
It was obviously highly usable in that community hospital. THe
handwritten notes OTOH in that folder were ghastly.
>What happens to all the scanned letters? - are they printed out again
when a
>patient leaves the practice, if not how can the next GP refer to
previous
>hospital correspondence etc.
And another theme is that some notes or letters are discarded...
I expect to find 4 letters or other pages in the old notes about a
surgical episode or medical admission. I expect to throw out three
of them, perhaps extracting a datum from one to add to the surviving
sheet.
>We need to encourage some of our more sceptical colleagues that
computers
>offer real benefits when used *live* during a consultation.
I feel no need to convince anyone of this. I simply carry on doing
it. I do seem to be collecting patients who deregister from my
sceptical
colleagues. An aggressive programme of stripping out duplicated
material
and whitespace from paper notes,
and putting results onto electronic storage is keeping the
shelf-length nearly constant, but I may still have to buy another
three metres of shelving this year.
>Perhaps transferable EMR may be a useful step in the right direction.
Yes.
Introducing it through co-op links and PCG links is probably the way
to go.
--- OffRoad 1.9r registered to Adrian Midgley
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