For many, just the word "EMR" conjures up thoughts of extra hours of work, cost, and frustration. Since legislature passed requiring all physicians to ultimately transition to this technology, many have viewed it as a burden. Electronic medical records, however difficult to set up, can actually carry with them many benefits that will ultimately help your practice. In this article, some of the top ways EMR may help your ophthalmic practice are highlighted.
1. Record recall
Working in an academic institution with multiple locations, oftentimes a patient will arrive to our facility and their chart from another. This certainly can occur in private practices with multiple offices as well. With EMR, not only are medical records accessible instantaneously, but they can be accessed from multiple locations. Dr. Amy Banooni finds EMR to be helpful in this regard, especially when on call. "I'll receive a call from a patient or have to see someone in the hospital, and the ability to bring up their records from any location is particularly helpful to give me a good background history. Oftentimes we rely on the patient to give us information such as what medication they’re taking. Now using an EMR I can see that the patients are often incorrect and it's really important to have instant access to their records." Of course, expansion opportunities become less daunting for growing ophthalmic practices as well – rather than relocate, copy, or fax thousands of pages of medical records, now an MD only needs to bring a laptop computer and the office can be with them always.
2. Cost
While startup costs for EMR systems can be significant, the ability to go paper-free conserves significant resources. Besides the obvious smaller items such as paper and toner cartridges, large amounts of physical space once used for massive chart libraries can now be liberated to use for alternative uses. Alternatively, newer practices can start out in smaller spaces bringing down any rent expenses. Another benefit of EMR is possible increased revenue via improved billing; Several programs have analytic elements that review the history, exam, plan and make recommendations as to what information/exam details can be added so that the physician can bill at a higher level. Many times this can save a physician from unknowingly undercoding a patient for a visit.
3. Communication with other physicians
Several EMRs allow letters to be drafted with pertinent information such as past medical histories or examination notes. Alternatively, others provide this data so that it can be simply copied and pasted. In either case, drafting letters to colleagues becomes a quick task. Furthermore typed histories, examinations, assessments, and plans are much more legible than our traditional "doctor's notes". In addition, hospital-wide EMRs allow physicians to access consultation reports faster. At the Veterans Affairs hospital in Miami, FL, a hospital-wide EMR allowed me to quickly reference patient's last primary care visit. This was helpful to confirm if the patients' blood pressure/sugar were controlled, but also uncover any unusual information. For example: I saw a patient with acute iritis. Review of the medical chart found that she was scheduled for a chest x-ray for mild shortness of breath. Via the VA system I was able to expedite the x-ray which uncovered the diagnosis of sarcoidosis.
4. Protection
When medical audits occur, all information is easily and readily accessible, allowing any procedures required to occur more smoothly and efficiently. Regarding patient protection, current encryption software continues to make accessing HIPAA information more difficult for unauthorized individuals.
5. Prescriptions
Many EMR systems allow prescriptions to be submitted electronically. This negates the possibility of the patient losing the prescription between your office and the pharmacy. Refill reminders can come up in advance, removing those after hour "prescription refill" calls. Additionally, the prescription can be filled more quickly, also ensuring the medication is in stock when the patient presents to pick it up.
These are not the only benefits of EMR, but rather just a sampling of the assets EMR can bring to a practice. There is no question that electronic medical records are the future of healthcare. As software becomes more fine tuned to our needs and our equipment is upgraded to better interact, transitioning to EMR should become much less headache and much more relief. Dr. John Kitchens, partner at Retina Associates of Kentucky, looks forward to an EMR that utilizes new breakthroughs in computer technology, such as the Ipad. "I envision being able to enter a room with just a touchpad and within a few strokes of my finger or quick dictation into the device have a complete exam registered in electronic format. Additionally I can see the computer advising me on the diagnosis and treatment based on my findings. While that will take much longer to occur, it may help clinch a difficult diagnosis one day."
Of course for younger ophthalmologists such as Dr. Kitchens integration of computers with medical care does not seem as big a change as it may be for others. For those physicians who have minimal computer access in their office, now may be a good time to begin to outfit lanes and become familiar with the general software programs. Like anything else, a good foundation in computer literacy will translate into hundreds of hours saved later trying to solve problems. These ophthalmologists should also look for the most simple-to-use (but perhaps not as advanced) EMR systems.
While no system is perfect, one that deserves mention is ifa systems AG, a strictly ophthalmic EMR. Currently the leading vendor for EMR software in ophthalmology internationally, over 7,000 eye care professionals currently use their system. In addition to being able to integrate with over 400 devices, it provides seamless integration with hospital information and practice management systems.