A couple of years ago we faced a lack of office space for our patient charts; we considered purchasing more space. As I’d been examining EMR systems for ophthalmology practices, it felt like the time to go paperless was finally at hand. Since that time we’ve planned out and worked on severing our ties to paper record-keeping.A full conversion to an EMR system requires a substantial investment in terms of both time and money. As we are a medium-sized practice with nine physicians and more than one hundred staff over five locations, we have the required staff and resources to realize this goal. But what can a smaller practice do, or one which cannot financially commit to such a large project?
Electronic medical records (EMR) systems require the input of data, and stores it electronically into a database. The data can then be utilized in a nearly limitless way – or at least the limits are set by the software and the imagination of the user. EMR systems with increased levels of flexibility can be intimidating to the novice, which includes most of us physicians. However, once a system has been set up and modified, an EMR system can be quite powerful. In short, the more extensive the customization on the front end, the greater the end user rewards on the back end.
What are alternatives to a totally digital electronic medical records system if a practice wants to bypass the initial expense and effort to customize these systems? Some medical practices have purchased EPM and EMR products but aren’t using them at full ability. Staff write notes as they usually would, which are then scanned into the system. This is called a ‘scanning solution.’ Many EPM systems, regardless of if they have EMR or not, contain a module for scanning letters, paper records, or photos. The result is called an EMR/EHR, or electronic medical record or health record. However, because there’s no actual data entry required by the user, it’s not a true EMR system. The advantage of using this type of system is that practices can use the existing EPM to process the volume of paper documents without the expense of another EMR system.
This same practice can then shred documents as they are scanned in, eliminating the need for storage space. There is a disadvantage here, however – since clinical data isn’t entered into the system, it can’t be retrieved for meaningful use. For example, the system probably couldn’t follow a trend in interocular pressure over time, or pull up all the patients who have been prescribed a particular medication. This sort of information may be extremely valuable for info auditing, as in the case of pay-for-performance reviews.
A less-expensive alternate would be a stand-alone scanning solution; for example, the one offered by SRS Software: srssoft.com. This could be used by practices which don’t have a complete EPM system in place. The solution can also be a temporary measure as a medical practice chooses a complete EMR system. Scanning solutions can also be quite useful for archiving large volumes of paper records. Again, no data entry is required as this is a digital copy of handwritten charts. Some of the benefits of using a scanning solution like this are that they have a small learning curve, lower costs, and no require no real change in the way physicians normally work. These systems have a higher implementation success rate, as compared to EMR systems.
Finally, practices which aren’t yet ready to depart from the comfort of paper records still have ways to increase efficiency while making patient charts more legible. Many practices use hand-written notes on blank paper, written by the physicians. It is unfortunate that these records are too often misinterpreted in audits, so the time savings of jotting a quick note can prove to be quite costly if misunderstood. Several forced-entry forms require the checking or circling of symptoms and signs, along with clinical findings, in an entry. These ensure that the appropriate components for billing and coding are included within the documentation.
By the way, do you want to learn more about implementing EMR in your own practice? Download my free report “Getting Through The EMR Maze.”Do you want to learn more about increasing revenue and cutting costs in your practice? Download my free report “The 7 Key Strategies To Building A Successful Medical Practice Even In Tough Economic Times.”Peter J. Polack, M.D., F.A.C.S., is founder of emedikon, a medical practice management consulting firm and president of Protodrone, a software development company specializing in medical practice applications. He is managing partner of Ocala Eye, a large multi-specialty ophthalmology practice.
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