Our office flow is...in a word, difficult. We each have scheduled pts, as well as a slew of walk-in pts. The latter are "up for grabs". We each pretty much try to grab a walk-in chart in between every (or every two) appts. It's not an ideal system, BY FAR. The appts. invariably end up waiting longer than they should. We are contracted with our HMO as an Urgent Care as well as a Primary Care practice, and so we have to take walk-ins. We also are Civil Surgeons, and do INS exams - plus we do W/C, and DMV physicals, etc. And those are almost always (unless they are a recheck) walk-in pts. The only saving grace, if you will, for our Primary Care pts. is that they know that they too can come in as a walk-in if the appointment schedule is filled up. That doesn't always assauge their frustration, but it helps.
Our current system is all paper charts. We have a rack for the appointments and another for the walk-ins. We use a "smart chart" template to speed up the charting. Some of us write more than others - I am probably the wordiest of us all. (Since I am a hunt and peck typist, that's another reason why I was drawn to Dragon).
Added to all this, we have the issue of two docs circulating randomly amongst the 8 exam rooms, including a minor trauma room which is used for lac repair, procedures, etc.
We used to have two M.A.s assigned to each doc - one for rooming and one for procedures (we do on-site CBC, chem, XRays, etc.) Unfortunately, the "rooming M.A." would sometimes just kick back and not help out the others if all their rooms were filled. So now, we just have four M.A.s circulating and doing the work for the two docs. When the M.A rooms a "walk-in" pt., since they don't know who will be seeing the pt., they will have to send each walk-in pt to both docs working that day, and then whoever "grabs" the pt. first goes to that room. Is that possible with AC (for the pts. to be sent to two docs inboxes instead of just one?)
The only thing I liked about a laptop/netbook for myself, is the fact that I may well be the only one using Dragon. To install DNS on all of the computers in each room would be unnecessarily costly, and not feasible - I think you can only install one licensed program on up to 5 computers, and even then, it can only be used on one computer at a time. And, I'd have to have a mic for each room, or go aorund plugging one in all the time. Ugh! I would rather carry around my netbook and my little stylus-sized microphone that clips onto the computer, and dictate as I go. The other docs would either utilize a portable
tablet, or (more likely) type/mouse click their way through AC on the computer in the room.
We are going to be doing a MAJOR renovation of the office in the next year, so it's definitely the right time to think ahead in terms of our EMR needs!
