Productivity first, electronic records second

A few months back, Carolina Oncology Specialists(COS) purchased a product named Varian and implemented it in the office. This program performed its duties as a comprehensive data repository but ultimately, it lacked flexibility and was not productive for COS. There was also no benefit to the patient experience. In fact, the experience was so counter-productive that the staff at COS demanded to return to paper charts. Kudos to salesmanship.

But the client base (unfortunately) at COS is growing and it is clear that a paper charting system will not scale. If an EMR system was not needed now, it would be soon. This is where I come in.

Before I began the implementation of any type of EMR system, I conducted interviews with the staff and did some research into the oncology EMR products on the market. There are innumerable products, each claiming to be 'easy to use' and completely interoperable with other products. Some by large vendors, some by small open-source communities. We signed up for a few interactive demos and had phone conferences with sales people but none could offer the features needed by a medium-sized oncology practice like COS.

The Oncology clinical workflow is different from most medical workflows. Not only do drugs need to be ordered and labs reviewed, but entire treatment schedules need to be managed. Many of the patients are in-patients and need to be monitored not only between office visits, but during one, as well.

Busy Doctors, nurses and administrative staff just don't have time to fiddle with clunky interfaces ill-designed for minute-by-minute patient tracking. My job has become to help this office not just convert their charting data to an electronic format but also to provide a product that will _improve_ their office efficiency, quality of service and patient throughput .

COS (and Oncology practices, in general) need more than an EMR, they need an patient tracking engine.