http://vimeo.com/54299546

Epic- while the ED template we were using was a bit cumbersome, and some of my colleagues had a backlog of charts, could be made very efficient. It benefitted and suffered from the ability to build text macros ie “advised the patient to follow up with their primary care provider. Pt verbalized understanding of all instructions given and agreed to return to ED with any worsening of symptoms.”
I could add that to a chart with 3 key-presses. Of course, if you have too many macros, your chart becomes useless, as it looks just like all the other charts.
Our hospital also got all the inpatient services and many of the local docs onto epic, which was fantastic, because I could see office notes and progress notes, which you can’t ordinarily see, and also outpatient testing not performed at the hospital.
With a template that’s more like a t-sheet with an area for free-text MDM- Epic would be the bomb.

I currently use a t-sheet with meditech for order entry and records. As mentioned above, meditech is slow, allows access to a single patient at a time, and often locks up. I have no major complaints about the t-sheet.
Admin, in their infinite wisdom, is going to force Meditech charting on us at some point. Having seen the demo version and read online about it, I’m not looking forward to this. I’d almost rather do the t-sheet for my billers and coders and dictate for my inpatient colleagues (except that’s double work). meditech appears to produce a difficult to interpret, slow to generate, poorly formatted medical record that will not help anybody.

I now have a wonderful EMR. In clinic from 9a-5p(with hospital beforehand) with 90 minute lunch. Rarely done with the AM clinic before 1pm and notes are never done by then. Lunch is maybe 20 minutes on average. Out of office 5:30-5:45 and frequently do some notes from home or come in early on days I have lower hospital census to do charting/paperwork(yeah, still lots of that with our ‘paperless’ system). So fewer patients seen in a longer time and have to do work when ‘off’ from home.
BTW, it is no easier to hunt down an old ECHO/stress test/consultant note/last lipid panel/etc with the EMR than it was with a well-organized paper chart.
And no, our EMR does not communicate with the hospital nor any local consultant.

Furthermore, it’s easier to multitask with a paper record. I can check boxes and write orders while I’m standing in the room with the patient. But I can’t do that as easily with the computer EMR. Again, if I glance down at my paper while talking to the patient and check some boxes, they don’t get upset if I lose eye contact for 10 seconds. But they get annoyed if I log onto the computer and look away from them for 3 minutes while clicking on the computer.