TECHNOLOGY

  EHR

Are You Using EHR to Its Fullest Potential?

How to maximize the capabilities and profitability of this technology

JOHN WARREN, O.D., RACINE, WISC.

Even if you have transitioned from paper charts to EHR, you may not be fully benefitting from its capabilities.

Though my practice is currently at a level of integration that has increased our efficiency, this did not happen overnight.

For example, we manually entered data from our refraction system into the EHR for several years. Even though we were experiencing the benefits of the refraction system, we weren’t taking advantage of the gains of integrating it with our other technologies. While it took only a couple of minutes per patient to enter the data, this time added up during a busy day and created the potential for data input errors. As a result of this and similar situations, I knew that I had to improve the level of integration among my EHR and other in-office technologies.

Here, I explain the areas where your practice can get the most out of its EHR technology and how you and your patients can benefit as a result.

Appointment scheduling

Just about every practice management product is integrated with communications partners that allow your current and future patients to book, confirm and reschedule appointments. This saves time for your staff because they don’t have to call patients for these purposes, and patients love the flexibility to make appointments outside of your office’s business hours.

Billing records

Most EHR systems have patient portals that allow them to access their billing information.

For example, patients can view summaries of what they paid for your services at the end of the year or during their tax preparation. If just a few of each week’s patients call your office while preparing their taxes, your staff can easily spend a few hours per week preparing and mailing (its not OK with HIPAA to e-mail these types of documents) this information to patients in addition to the cost of paper, printing and postage. Through an EHR’s patient portal function, staff does not have to receive calls requesting this information or take the time to gather and send it to patients.

To inform patients that we offer this service, nothing is as effective as personally telling each of them about our patient portal at the conclusion of their encounter. If they don’t currently have access to their personal health record (PHR), I have my staff set them up and get them their login credentials before they leave the office. Patients greatly appreciate the ability to access their billing and health information at their convenience.

Patient history

Some EHR systems can be used for patients’ “intake interviews” prior to their appointments or in your office via their smartphone or digital tablet. These entries go directly into the patient’s medical record, so there are limitations to just what data can be entered and/or changed.

It is not common practice in the EHR world to allow patients to make direct entries into their medical record for current medications and review of systems entries. However, having patients enter data about their present illness, purchasing plans and desires for contact lens services creates direct entries into the medical record, saving staff time and improving the efficiency and accuracy of the data collected and entered.

My patients receive an e-mail reminder about their upcoming appointments. That e-mail has a link to confirm the appointment, as well as to log into their PHR and take their patient intake interview. I tell each patient at the conclusion of each encounter to expect that e-mail, and I explain what they can expect to do when they receive it. Notifying the patient at the end of the exam has been the most effective method at spreading the word.

Also, many diagnostic devices allow you to access patient records and share them throughout your office. Via direct cabling between the devices, “card readers” that move the data from one device to another or via your office/computer network, your autorefractor and lensmeter may be able to send data to a refraction system or directly into your medical record software. This removes manual data entry and prevents transposition or inaccurate data entry, such as patient prescriptions for spectacle or contact lenses after refractions.

Also, you can use your imaging/diagnostic instruments (visual fields, topography, OCT, fundus cameras, etc.) to upload a “flat file,” or electronic version of the device’s printout of exam data, into your EHR, but why limit yourself? Many of these devices now provide viewing/manipulating software that enables you to review, mold and interpret the output from their device. By archiving the data and accessing it via such software, you can use the data as though you are at the device itself.

For example, before seeing each patient, I review their medical records, aberrometry and fundus images via each device’s viewer software. Also, I look at patients’ past and current visual fields and/or OCT exams before a follow-up or imaging visit. Then, I perform any needed exam and present the results to the patient, utilizing their own imaging studies to explain the findings. Patients seem to be much more engaged in what I tell them and their prescribed treatment when educated via their own examination data.

Become fully integrated

Some optometrists have purchased EHR due to government reward in the form of bonus Medicare payments or in anticipation of future requirements rather than want. So, some may view the technology with disdain rather than regard.

Consider this: Failure to use it to its fullest capabilities is impeding your practice’s ability to maximize efficiency and improve patient care and the patient experience. OM

Dr. Warren practices at the Warren Eye Care Center. Also, he is a consultant for Marco. E-mail him at cjwarrenod@gmail.com, or send comments to optometricmanagement@gmail.com.