Primitive to Paperless in 6 Weeks

Today’s post comes from Dr. Bill Adams. Dr. Adams is a pediatrician and he works at Triangle Pediatrics in Cary North Carolina. His office recently went live with an EMR. He wrote a really nice summary, so I asked him if I could publish it on the blog. He agreed, so I wanted to share it with you.


  • EMR Live 6/7/11
  • 7 providers, up to 65 years old, with 18 staff support, one location
  • 31,230 charts gone (Two rooms), National Scanning,Inc., review of that company to follow.
  • Office Practicum EMR and PM
  • Eprescribing and Instamed claims processing implemented
  • Dell T610 Dual Core server,and backup server
  • 13 Lenovo X220T I5 laptop/tablets (all day, no recharge, Gorilla glass, pen/touch/keyboard)
  • Standard DSL (No T1)

Well, we’ll just have to see how this goes. Of course we are certainly not counting our chickens yet, but it hasn’t been as bad as everybody says. There are plenty of annoyances along the way, but no roadblocks. The days are longer at the beginning of this learning curve, but no late nights. We haven’t had to remove the knives and sharp objects from the office. None of the 25 staff lost.


  • Good advice from SOAPM members, and from other practices that have been implementing systems for the last 15 years.
  • Our office manager anticipating problems. Everything from implementation to handing out Starbucks gift cards to parents who may have waited a little too long at first.
  • Inexpensive, robust equipment. Our Lenovo laptop/tablets are now just $1100 and reviewed as best available, though not crazy about the smallish screen. Problems that are identified as the computer, have always been Windows rather than the machines. Dell Dual core server $3400. Good cheap laser printers, scanners.
  • Maturation of the EMR software industry (more debugged)
  • Windows 7, especially the smoothness of Remote Desktop at home, and Plug-and-play networking, compared to XP/Vista. Windows tablet has a way to go.


  • Wish government had mandated interactivity of systems, before broadly mandating EMR . Until then, I still regard this as all premature. A shame.
  • Wish the AAP could have harvested experience from its huge membership to set up an effective, useful EMR/PMS rating system. Too bad.
  • Wish it could have been ASP, all internet based. Chose not to.

Looking forward to:

  • Portal (January)
  • Thin clients in room instead of laptops ( needs a few technical improvements )
  • Direct connectivity of peripherals: CBC Emerald/PFT/Vital signs/hearing/vision. Hmmm, how do we do U/A results directly?

For Sale:

  • 40 linear feet of chart shelving
Thanks Dr. Adams for this great summary. Personally, I think the picture says it all. I also liked how he mentioned he didn’t have any roadblocks… annoyances, yes, but roadblocks, no.


  1. I don’t know about medical “EMRs” or “MRIs” for that matter…, but we have been using computers for 20+ years now. However, we have not gone totally paperless. Financial, insurance, scheduling. radiographs and many other functions are on the computer, but we still have an actual hard copy chart. We tried (last year) to use a new totally paperless system to chart treatment, record diagnoses, write prescriptions, etc. It was a total flop. Why? –because even with training, it took so long to record, go to a new computer “window”, type in the information, we could have done all that in one-fourth of the time with our normal system. It was inefficient. In pediatrics (and pediatric dentistry), volume and efficiency are critical. I have patients waiting! Proper customer service demands an efficient office. Perhaps, in the future we will try again, but for now, we have a hybrid computer/paper system.



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