Tap, tap, tap to better patient documentation.

Dr. Greg Hinson is in the minority. He's among the meager 13 percent of physicians in solo practice who use electronic medical records, according to a recent Commonwealth Fund survey. But Hinson is comfortable being apart from the madding crowd. He knew electronic record keeping would be the ticket to efficiencies in his practice so he traded in his hodgepodge of inadequate record-keeping techniques, said hello to an EMR geared to small and midsize practices and is engaging patients in a Web portal that puts them in the driver's seat of their healthcare. In August 2001, Hinson moved from a three-doctor office in rural Georgia to take over a similar size practice on Nantucket Island, Mass.—a community with a year-round population of 10,000 that quadruples the number of residents in the summer. Hinson supplemented his predecessor's handwritten notes and paper charts with notes generated by an early, limited EMR. When the vendor phased out the EMR a couple of months after Hinson moved to Nantucket, he experimented with a mixture of handwritten notes, homemade MS Word templates, macros, checklists and dictation. " If you opened my paper charts, you'd see notes generated in about four or five different ways, " says Hinson. " I was spending too much time documenting and way too much time hunting for paper charts. It was very confusing. " Photo courtesy of Greg Hinson, M.D. In 2003, Hinson began searching the Internet for EMR options that would allow him to not only improve documentation, but also involve patients more in their healthcare. After seeing several vendor names pop up repeatedly on physician-driven forums like physicianonline.com and emrupdate.com, he contacted those vendors, participating in a dozen online demonstrations. When Hinson would describe his staff size—a nurse practitioner, medical assistant and receptionist—and patient volume (approximately 45 a day), vendors would stop Hinson midsentence and say, " You can't afford us. " The market was not friendly to small practices of fewer than 10 doctors, Hinson contends, and instead catered to medium and large physician practices of 40 to 50 docs who could justify the time and expense of customizing a product. Hinson soldiered on and after a year, narrowed his choice down to two vendors.