How EHR Can Drive Efficiency

Move past regulatory fears and start benefiting from EHR.


EHR: The benefits of Your New Addition


Get past EHR implementation “labor pains” by taking advantage of the efficiencies offered by your “newborn” system. Here’s how.

By Darla Shewmaker, Villa Hills, KY

According to the Medicare EHR Incentive Program September 2013 report, 6,874 ophthalmologists have qualified as a meaningful user for the government program. This number represents between 40% and 45% of the actively practicing ophthalmologists in the United States.

Over the last 17 years, I have worked with many practices implementing electronic health records. Each has its own “birth story.” Gratefully, as time moves forward, the pains of labor fade and the joys of the new baby take center stage.

In this article, we discuss how to take advantage of your “newborn” by addressing efficiency gains made possible through EHR.

Improving Patient Flow and Processes

Surely some will disagree over whether an extensive evaluation of processes and patient flow is a bonus. If it isn’t broke, don’t fix it, they argue. Yet the mantra, “we have always done it that way” should not excuse bad or outdated processes. When transitioning from a paper to an electronic practice every step of the process needs a review and, most likely, an update. This detailed inspection may not have happened without your new medical record system. In the end, it will improve overall efficiency, update outdated concepts and improve patient care.

Eliminating Paper Charts

No one will miss searching for a missing chart. Electronic charts eliminate the need to:

■ Pull and prep charts for the day.
■ Copy records for referring physicians.
■ File charts at the end of the day.
■ Ensure all charts made it to billing.

Most practices are short on space. Removing volumes of paper charts from the building creates space for storage or additional treatment and testing venues.

Electronic Prescribing

The hours spent on the phone waiting for the pharmacist or returning calls for refills are dramatically reduced with electronic prescribing. According to Surescripts, your pharmacy is ready: “93% of community pharmacies (including 85% of Independent Pharmacies) and 10 mail order pharmacies in the United States were connected for prescription routing in 2012.”

Insurance Formularies are available with most e-prescribing systems—a requirement for any certified electronic health record. A formulary review will alert you or your provider to drugs that are not covered by your patient’s insurance plan and also show you options that are covered. Patients are more likely to fill the prescription that is covered (improving compliance). It also reduces calls from the patient or pharmacy searching for alternatives.

For those patients unable to provide a comprehensive drug list, many e-prescribe systems provide a medication history that can be incorporated into the electronic record providing the detail you need to prevent harmful interactions.

Replace Time Intensive Transcription

For years many physicians have spent countless hours dictating correspondence and patient chart notes. Outsourced medical transcription may cost a practice up to $10,000 per year per provider. Electronic records provide standard templates that can be modified to create correspondence specific to the condition. For example, the standard correspondence for a patient with diabetes may include the intraocu-lar pressures, medication list, an assessment of the current diagnosis and future plans for patient care. If your physician wants to add personal comments, voice recognition software can be added to include additional text.

Patient Care Summaries and Education

The highest goal is to improve patient care. Patients can now leave with everything they need in hand:

■ Laboratory orders.
■ Summary of the visit, including medications, medication allergies, lab results and diagnosis list.
■ Education regarding the diagnosed conditions. Connecting your patients to the internet may provide:
■ Visit summaries.
■ Educational items.
■ Test results.
■ Online appointment scheduling.
■ Secure messaging to send inquiries.

Embracing the Magic

Once the initial transition is over, the focus can shift to the perks paper charts could never deliver.

■ Trend Analysis: Summaries of IOP measurements graphed over time.
■ Remote Access: Complete information for after-hour emergencies.
■ Improved Accuracy for Coding: Most systems can assist in counting the necessary elements required for CPT coding and ensuring tests performed are billed.
■ Receive lab results and automatically make available to patient electronically.
■ Data Mining: Most EHR programs will provide a tool to search all patient records for information. As an example, all patients using a glaucoma medication that is being replaced by a new drug could be easily located.

  • Clinical alerts and reminders.
  • Outcomes analysis.
  • Image review and storage.

The path toward an electronic health record is now clear. A number of excellent systems are available and the upcoming changes for Meaningful Use Stage 2 are pushing each vendor to adopt new levels of interoperability.

In the beginning, it can take a lot of nurturing, cleaning up, and you may lose a little sleep, but after that you can sit back, relax, and enjoy the perks of the new life you have breathed into your practice. OP


Ms. Shewmaker has spent 17 years on the front lines of electronic health record design and implementation. She recently left her position as VP of product development and is focusing on ophthalmic practice consultations, education and compliance. You can contact Darla at