tech time

Your Problem With EHR?

I address the common reasons many of you aren't going paperless.

Scot Morris, O.D., F.A.A.O.

Now that I have your attention, let's talk about my January column, in which I asked what issues you have with moving toward a technology-based office. In response, I received more than 300 e-mails, letters, and phone calls.

Respondents brought up a lot of great points. As I read one response after another, I laughed because I got exactly what I asked for: the reasons why you, my fellow optometrists, are not joining the technology movement. So let me say “thank you” to all who replied.

Common themes

Now, let's address the common themes. Some said they were too old to switch from paper. The comment “it's too expensive” was common. There were those who said they tried and failed, and those who are still trying but struggling in frustration. Many said they didn't see enough Medicare patients or practice medical optometry, so they didn't expect to benefit from the Federal incentive program. There was the “I'm waiting for them to perfect it before I jump in” crowd (who sent messages by telegraph). But hands down, the best snail mail letter, sent anonymously from Pennsylvania, contained eight simple words: “Why would I? I do just fine now.”

The most common thread was that no one felt that EHR would make them more efficient. Well, you're absolutely right. EHR will not make you more efficient. Let me repeat: EHR will not make you more efficient. EHR is only a piece of equipment. The fastest car can't take you anywhere if you don't put gas in it and turn on the ignition.

Efficiency comes from process enhancements, most of which have nothing to do with the EHR you choose. Some of the peripherals can have a huge impact on efficiency, but those technologies, like EHR, are only tools. As discussed in past columns, the first step of technology integration is knowing exactly what you do to every patient, every second of their interaction with you.

In some cases, you shouldn't move toward EHR or other technologies until you've put on your CEO hat and truly figured out what you do. When you think you have the answer, ask staff what they do. Compare notes, streamline things, and after a few months, repeat the question. Guess what? The answer has probably changed.

Not the answer

EHR is a tool, not the answer. I can get from Colorado to New York by horse. It will take a few weeks, or I could just jump on a plane and be there in a few hours. Both modes work. In the right practice—one with systems in place—EHR allows increased efficiency for those progressive doctors.

Let me answer the rest of the comments. You are never too old to get better unless you are already dead. It's more expensive to use paper vs. EHR. If you are struggling or have failed, it was likely not the software but your office workflow that was the root of the problem. (As mentioned above, analyze how your office works.) Nothing on this earth is perfect, ever. If you are not seeing enough “medical” patients or participating in Medicare, then you have a great point—so long as you are very successful in the visioncare model. If not, time to get with the medical program.

And most importantly: Be a business person. Figure out what you do, then just do It.

Next month, I'll discuss advances in diagnostic technology. Be educated, be aware, and thrive in the optometric world of technology. OM