May 2017

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« Electronic Referrals — A Progress Report | Main | Job Descriptions Remain Important in an EMR-Based Practice »


Brandon Blanck

Forms are an incredibly difficult part for any medical clinic to manage, simply due to the sheer number of forms that are available. In Alberta, a study was done to determine the number of forms in the province; they stopped counting after reaching 30,000. Consolidation of common forms is a must, and likely requires provincial intervention, but a good EMR can help immensely. Healthquest currently contains over 1200 unique forms, and more are being added on a daily basis. Each one can be completed electronically with a copy stored in the patient's chart. It certainly helps with the drawers of forms, but we still receive requests for new or updated forms regularly.

Paul Mackey

Ah the tyranny of paper forms! We are a rural community with one hospital being the only radiology provider. For years we begged them to change from a duplicate, carbon copy form, which was becoming nonsensically useless (and expensive) for their and our needs. The one thing we ask was to please have some input into the layout (all we wanted was a spot for a patient label!). Well you can guess what happened. And then there is the memo, "Here is the new form. The old form will not be accepted and must be discarded".

Our EMR, MOIS can incorporate PDF forms which can be prepopulated with critical data to save time. However you can fall prey to the same tyranny of too many forms if you try and incorporate all the forms you may possibly use into the electronic system. Then you end up scrolling or searching through a huge long list and wasting possibly more time. We have kept our selection to the most important ones and have designated a "top five" which we have "float" to the top of the list.

Still come up against the problem of "Thou shalt use the new form without any prior warning" as these PDF forms can be complex to build and can't always be reproduced overnight.

Michelle Greiver

We are giving up on forms. We just use the Diagnostic req generated by the EMR. We change the address of the DI facility on top as required, using a drop down list. This produces a "generic" req. If I need a pelvic Ultrasound, I have the prep on the bottom, and it is saved as "pelvic US". We have had no problems at all, except for MRI at my hospital, where the clerk told me that she won't accept it, she wants "their" form.

I have to generate forms for public health lab (scanned in), they refused to accept generic. Specialist referrals are generally ok, except for a few programs that want a form. Our screening colonoscopy program at the hospital has now OK'd generic. Diabetes education welcomes EMR referrals with appropriate information, not forms.

People need the information, not the form. It is the information that matters. Eventually, it will be transmitted as electronic data.

My lab continues to insist on "their" form for histology and paps. I told them that if it is generated within my EMR, I can track it, but not from "their" paper-based form. My patient had an endometrial Bx that was cancer, and it was not sent to me as my address was accidentally truncated in the lab system. I knew other patients had recent histo, but could not find the missing reports as they ware not generated from the EMR. Paper forms are unsafe for our patients. The lab was informed and asked to consider changing their process to improve quality; this was 2.5 years ago.

Try sending a "generic" form generated from your EMR to the receiving organization, with no special formatting. The better organizations might just surprise you and accept it!

Forms are illogical, unsafe, and impossible to manage efficiently. They are a significant barrier to the transformation of care through the Meaningful Use of EMRs. Our provincial regulatory Colleges, as advocates for the protection of the public, should be asked to help us with this issue.


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