It's been nearly five years since Brown & Toland first launched the TouchWorks electronic health record (EHR) system. Since then, we've helped nearly 150 primary care and specialist physicians get on board.

In that time, we've also had a chance to really see what is working for physicians and which functions they like to use.

The pie chart below shows the utilization for the past month alone: more than 62,000 results viewed, over 91,000 prescriptions written and over 42,000 clinical documents stored.

Physicians are using a wide array of functionality and are seeing vast improvements in efficiency and financial gains. Some examples:

1. The use of Text and Medcin templates for note creation.
2. Dragon Voice Recognition system to replace expensive transcription services.
3. Full electronic prescribing using the SureScripts hub.
4. The complete elimination of the paper chart with associated cost savings, estimated to be about $18,000 per year for one of our physicians.
5. Enhanced communication across the whole enterprise using the secure messaging system (known as the TASKS module). As an example, PCPs are only referring to specialists who are also on the Allscripts system.
6. Access to a patient's chart information 24/7 on the web, from anywhere in the world. Quality of patient care is achieved through chart accessibility and integrity. The complete disappearance of the "lost chart syndrome."
7. Increased revenue from improved coding and recovered lost billings.
8. Patient safety improvements with the avoidance of adverse events through the use of drug-drug, drug-allergy and drug-laboratory alerts.

Allowing for sufficient time for installation and change in processes, practices with an EHR appear to have greater revenue and are more profitable than practices with a paper medical record. Take a look at this table:

This shows the mean two-year change in performance for PCP practices that installed the EMR in 2006, compared to similar practices with a paper record. The IT costs are understandably higher in the EHR group but the mean total revenue (after operating costs) per FTE physician is substantially higher.

I am sure you will agree that the information above is evidence that the time is right to switch over to an electronic system in your practice. Please feel free to share this with your colleagues who are not currently using an EHR in their practice.

Brown & Toland Physicians is working hard to continually improve and refine our electronic tools, especially the TouchWorks EHR system. We constantly monitor the system's performance and look at ways to enhance functionality and improve the user experience.

If we are to achieve our goals in this area, we need your feedback.

Please take our EHR user survey (created with surveymonkey.com). I would urge you to fill it out. It will only take a few minutes of your time. Besides answering the questions, feel free to add comments.

You can of course always contact me directly with any questions or suggestions.

Adrian Rawlinson is the Medical Informatics Director at Brown & Toland Physicians. Reach him at arawlinson@btmg.com.