Lisa,
    We went live with EMR about 3 months ago.  They took almost a month to 
transition to the Docs doing it on their own. It is beginning to smooth out 
a bit. We have "super users" in our bldg that are theoretically available 
anytime a Doc has a problem.  The one thing that would have helped us out 
the most would have been us being trained on their screens.  We have never 
seen the method they use to order on the computer so we can't talk them 
through anything. Our computer pathway to order is 100% different from 
theirs.  If you can familiarize your team with the Docs view it makes the 
phone calls much easier. While it is available for us to cancel and re-order 
we have been told specifically not to do so.  The clerks are not supposed to 
do it either (I think to force the learning curve) but it happens all the 
time.  If we talk to a Doc who clearly doesn't get it and we know he is 
sincerely trying, we explain the best we can from our end and we change it 
for him/her and they get a copy in their e-mail that they have to sign.
    We have a few Docs on board who consistently order wrong and when they 
can't figure it out they order Ultrasound Consult and type a long sentence 
into the special comments line.  That one gives us the most grief. We 
immediately call the Doc and they tell us immediately they can't fix it they 
aren't even in the bldg anymore (with in 2 minutes) and sometimes they will 
blatantly say "I don't know how to order for your department"  One of them 
is wonderfully charming about being computer handicapped, two of them are 
horribly arrogant about "not having the time for this!!!!!)
    And as usual getting an actual symptom is always a problem.  We have 
programmed in the acceptable (read payable) list. Sometimes they even ask us 
"well, what's acceptable?" We appreciate that they want the insurance to 
cover the test but we do try to stress the symptom should be appropriate to 
the test. We have learned to ask what information are they trying to glean, 
not what test did they think they wanted.  It seems to all be in the 
schmooze.
    Back to EMR....when DMC went live, they spent almost a year hyping it to 
us.  They came through the department, they hung posters, they sent e-mails, 
all stressing that it was going to be bad for a while but that with patience 
we would all get through it.  I guess kind of like a spinal tap or getting 
married.  Do all the prep available, hope for the best, prepare for the 
worst, grit your teeth and smile on the phone.  When all is said and done it 
will all be over and it gets a little better everyday.   BS

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