The evolution of electronic health records (EHRs) in the Digital Era has helped drive improvements in many aspects of the medical field, from operational efficiencies to patient care and outcomes to population health analytics. As EHR solutions become increasingly sophisticated and specialized, many ophthalmologists are seeking to incorporate new, innovative capabilities into their practices. Before choosing a new EHR resource, it’s important to bear in mind some key considerations.
The role of the ophthalmologist in the EHR evaluation process
When assessing new potential EHR solutions, the ophthalmologist should take the lead in the review and decision-making process, as the subject matter expert of the practice and the person whose work will be the most significantly impacted by the selection. This does not mean the process shouldn’t be a group effort. The ophthalmologist should also assemble and oversee a multidisciplinary team to consider the decision from all angles and gain comprehensive perspectives and insights on how the EHR will fit the overall needs of the practice. As the leader of the practice, the ophthalmologist should also clearly define roles, responsibilities, and expectations for implementation and onboarding with all team members so everyone understands their contribution to the review process. This helps mitigate confusion and workstream gaps while supporting a smoother transition once the new EHR tool is chosen.
Points to ponder when weighing EHR options
The first aspect to assess, of course, is the core functionality of the EHR, as well as if and how it will meet the needs of the ophthalmologist, the patients and the practice as a comprehensive organization, underscoring the necessity for a cross-functional review team. Integration and compatibility with current workflows and systems is critical, as the new software will not exist in a silo but need to integrate with the practice’s existing assets. Defining the function of the EHR (in extensive detail) within the ecosystem of the practice is crucial to its success.
In addition, financial and operational projections must be considered. For example, how will the new EHR solution enable staff members to get more time back in their day and what other efficiencies does it offer that drive profitability? Further, a new EHR solution should also include regulatory performance monitoring and documentation to support the practice’s compliance. As the ultimate goal of any practice is to provide the best possible patient care, the EHR solution should optimize the financial and operational aspects of the organization so clinical teams can focus on increasing patient face time, engaging in meaningful interactions, and achieving positive outcomes.
To guide the right conversations with potential EHR vendors, it’s important to ask plenty of questions in the review and selection process, such as the following:
What specialty- and subspecialty-related functionality does the new EHR solution offer? When evaluating options, ophthalmologists should ask potential vendors what features it has related specifically to ophthalmology and subspecialty documentation needs (e.g. related to retinal care, glaucoma, pediatrics, and others). If it is too generalized and not purpose-built, it won’t meet the particular needs of a specialty practice.
Is the EHR solution configurable and flexible enough to accommodate necessary changes on the fly? Are changes easy enough to be self-serviced or will they require vendor assistance? Agility is vital to any business, and it is especially necessary in the rapidly evolving medical field. EHR software must be able to pivot as nimbly as the needs of the practice dictate. If a practice needs to make a configuration update or similar change, extensive (and often expensive) field service costs and associated system downtimes could be highly disruptive.
Are there statistics on solution performance and ROI? It is highly beneficial when evaluating new EHR software to secure any quantitative information the vendor can provide to support a data-driven decision. Even if it must be cleaned or aggregated, it will help to have real-world data to set realistic expectations of performance.
What resources does the vendor provide in terms of onboarding and implementation? Beyond the technical capabilities of the EHR, it’s important to understand what training, support and troubleshooting assistance will be provided, as well as what timelines and SLAs can be expected. A written schedule of this support should be included in the vendor’s proposal and should be a part of the evaluation team’s records.
Steps to preparing for a new EHR solution
To conclude, there are a few simple yet significant steps any ophthalmology practice should take if considering a new EHR solution:
Performing an audit of the practice’s current EHR software: Completing the exercise of a detailed needs analysis will help determine what gaps exist and what the practice’s goals are in implementing a new EHR. From this exercise, the review team can then build a roadmap between current and future (desired) states.
Developing a project management plan: Documentation is key, including a regular cadence of communication with a multidisciplinary team, definition of key milestones, any transitional steps and other logistical elements.
Researching and reviewing potential EHR options, recording notes in the process: When deliberating between several options, comparisons can become confusing without thorough documentation of each solution’s key points. One of the assigned roles in the multidisciplinary review team should be to manage the staff’s inputs and commentary on each potential option.
Coming to an agreement with the vendor on a go-forward plan: Once selected, working collaboratively with the chosen vendor to create a mutually agreed upon implementation plan and schedule, measurement of KPIs and any other relevant inclusions, will support a more seamless transition.
Choosing a new EHR solution is not a decision to be taken lightly. It Is a decision that impacts the entirety of the practice and thus should be examined from every angle. Using these considerations and guidelines will help ophthalmologists and their staff be methodical throughout the process of upgrading the practice’s operation.
Jason Handza is a vitreoretinal surgeon and Chief Medical Officer for Nextech, a comprehensive specialty-specific EHR & Practice Management provider. He is based in Trinity, Florida, USA.