Role of the Clinical Pharmacist in the Successful Implementation of an Electronic Medical Record in an Interdisciplinary Diabetes Education and Research Center

Purpose: The Diabetes Education and Research Center (DERC), is an interdisciplinary clinic, providing comprehensive family and community centered diabetes education and care for children and adults at risk for diabetes or its complications. Implementation of an electronic medical record (EMR) was pursued to enhance documentation, track interventions by students, residents, clinical staff, and for reimbursement. Prior to EMR implementation no electronic capturing of data occurred.

Methods: The EMR transition necessitated a decrease in group educational classes and number of patients seen. This was corrected as providers adapted. Existing paper charts were scanned into the EMR. The pharmacist championed to ensure allergies and medication lists are accessible to the providers, accurate, and appropriate medication/allergy alerts were in place, as well as integration of a pharmacist template.

Results: Implementation of the EMR in this innovative practice setting resulted in clearer documentation, facilitating better communication amongst providers and consistent patient follow-up. A decrease in no-shows and increase in patients completing program components was demonstrated. Improved documentation and integrated billing processes led to an increase in revenue.  Challenges for the pharmacist associated with implementation of the EMR include: timeliness of interaction documentation affecting provider communication, necessitating ongoing education, updated computer systems and additional workstations.  Ensuring provider utilization of information entered from various disciplines has been challenging. Notes are not displayed unless the individual disciplines tab is selected, and tabs are not integrated or time stamped on the home screen. Establishing EMR access for multi-disciplinary rotation students has been challenging due to need for appropriate clearances through the remote desktop, which holds the EMR application.

Conclusions: Implementation of the EMR has resulted in improved clinic flow, patient follow-up, documentation, and revenue. The challenges of timeliness of provider documentation, provider utilization of interdisciplinary information, and EMR access for students are being addressed on an ongoing basis.