1. The Electronic Medical Record: A Tool for Teaching Nancy B. Clark, M.Ed. Director of Medical Informatics Education, FSU College of Medicine For GRIPE Annual Meeting, 1/23/2003

2. Goals for this session AAMC Informatics Objectives Selecting the EMR Using the EMR in the CLC Educational objectives Hands on Experience

3. Resources/Reading Rakel, R. (2002) Electronic Medical Record. In: Rakel, R. Textbook of Family Practice, 6 th Ed. W. B. Saunders & Co. pp 1635-1645. Available in MDConsult.

4. AAMC MSOP Medical School Objectives Project Medical informatics’ use in five major roles played by physicians— Life-long Learner Clinician Educator/Communicator Researcher Manager http://www.aamc.org/meded/msop/msop2.pdf http://www.aamc.org/meded/msop/msop2.pdf (June 1998)

5. Role of Clinician Retrieve patient-specific information from a clinical information system, demonstrating the ability to display selected subsets of the information available about a given patient

6. Role of Clinician Make critical use of decision support, demonstrating knowledge of the available sources of decision support which range from textbooks to diagnostic expert systems to advisories issued from a computer-based patient record.

7. Role of Clinician Document and share patient-specific information, demonstrating the ability to record in information systems specific findings about a patient and orders directing the further care of the patient. Use security-directed features of an information system

8. FSU Strategy No clinical activity – no real patients Clinical Learning Center - simulated patients History Taking Physical Exam Documentation? Electronic Medical Record System! Request for bids

9. Practice Partner Donated 40 user licenses Established in 1985 5000+ doctors using 30+ residency programs Practice based research network Decision Support Drug interactions Drug allergy Knowledge base links

10. Practice Partner

11. Hardware Configuration Server Databases Wireless node Client Tablet PC

12. Using Tablet PC Wireless, touch sensitive handheld Windows computer Stylus Cradle with keyboard and mouse Used to score student performance Used to access medical record and document encounter Access medical information at point of care

13. EMR

14. Using Tablet PC

15. EMR Educational Objectives Access patient information Documentation of Progress Chronic Disease Management Coding Communication Decision Support Patient Education Handouts Prevention/Health Maintenance Security and Privacy

16. Simulated Patient Cases Past Medical History Social History Family History Lab data Multiple problems Multiple medications 4 dimensional Training site CLC Doctoring small groups PBL sessions Lecture/grand rounds

17. Quality Care Knowledge Management Clinical Information Management Order entry, EMR, Billing Communications Decision Support

18. Resources on EMRs Electronic Medical Records at AAFP http://www.aafp.org/x432.xml Computerization at FPnet http://www.aafp.org/fpnet.xml Computerized Medical Records http://www.healthcare- informatics.com/issues/2002/05_02/spotlight.p df http://www.healthcare- informatics.com/issues/2002/05_02/spotlight.p df

19. Hands On Experience Using Practice Partner EMR