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ple back to the operating room because there was nothing document- ed. You have to have a mechanism that lets you switch over to paper at that point. Some can't type, but the counter to that is that most peo- ple can type and the clarity is far better than trying to read someone's chicken scratch. We now use a voice-recognition program called Dragon, and it works pretty well. Another problem is that unfortu- nately, people sometimes cut and paste. So instead of getting all the information from the patient or the patient's family, they'll cut and paste somebody else's information. That's problematic in that mis- takes can be carried over. Q: How did the EMR help improve your on-time start rate? A: For many years, we were looking at on-time starts in a binary fash- ion. A case either started on time or it didn't. But by 2010, we realized we could put some sub-menus in and have the OR nurses record whether the case was delayed due to the surgeon, the anesthesiologist, the nurse or other. Then we could collect that data, bring it back to our service chiefs and they could talk with the people who were responsi- ble. What we found was that a very small number of people — 5 out of 71 surgeons — accounted for about 30% of the delays. That becomes very powerful when you can bring that data back and show people. Surgeons and anesthesiologists are pretty competitive, and none of them want to be thought of as the tail-dragger. So initially we showed the information at our OR Executive Committee meeting, and then we started socializing the data by publishing it and putting it up in the main OR and the OR lounge. Q: Could you compile that kind of data before the EMR? A: We'd thought about it, but everybody thought it was going to be too labor-intensive. Our software lets us do an extract transfer load — a data dump, if you will. So if I had a surgeon in my office right now, with 4 clicks I could show not only the block utilization for his service 5 0 O U T P A T I E N T S U R G E R Y M A G A Z I N E O N L I N E | F E B R U A R Y 2 0 1 5