A hot topic among many physicians is the “evils” of electronic health record (EHR) systems and how they represent a unique and vexing challenge to physician professional satisfaction. As a physician who has used an EHR in my practice since 2004, I truly believe this tool represents one of the best technologies that I have adopted in my practice.
Instead of dwelling on the challenges that physicians face in working with EHRs, which are well noted, let’s discuss some ways an EHR can actually improve our lives and practices.
Physicians must learn to roll with the times and adapt how we function with the new way of practicing medicine-and use it to our advantage.
No more lost charts
I will never forget my first few years in practice as an endocrinologist when we were still using paper charts.
Whenever another physician or other person would call about a patient, the chart was frequently missing in action! It could be in the medical assistant’s office, the billing office, the lab, or heaven forbid, in a big stack waiting for dictation. Crucial lab values and imaging results would often be separated from the chart until it was finally discovered.
With an EHR, you will never have another lost chart. Simply go to your computer, type in the patient’s name or other identifying information and, voila! There is your chart.
One thing to keep in mind with an EHR system: Have someone back up your system continuously so the data is never lost in a computer graveyard.
Transcription is archaic
With a computer in every exam room, we document all our notes while in the room with the patient during the visit.
In my experience, most patients do not mind the provider looking at the computer often because they realize that this is the most accurate way for the provider to access their data and document new data. Documentation while you are with the patient improves accuracy and saves time.
By doing this, there is no documentation required at the end of the day, when you might be trying to remember details about 20 or more patients. Not to mention the fact that when the note is done, it is immediately ready to be billed.
Code your own notes
No staff member knows what happens in the exam room better than the provider. Only the provider truly understands the complexity of the visit, the decision-making involved, and the time that it takes to counsel the patient, provide prescriptions, order tests, etc.
An EHR helps with coding because it offers suggested codes based on what is entered into the templates.
However, providers should not be lazy and let the EHR do all the work. If the provider believes that the Current Procedural Terminology code should be billed “higher” than what was charged, then additional information might be needed to document the code properly.
NEXT PAGE: How to get rewarded for excellent care
Access charts from anywhere
Isn’t it frustrating to be stuck in an airport attempting to attend a meeting, and thinking about patient charting that needs to be done, including reviewing labs, imaging reports and more? Don’t you wish you could make use of this lost time to get your work done so that life is easier when you return?
With the help of your information technology consultants, you can access your EHR on your laptop, iPhone, iPad or other mobile gadget. We are a society “on the run” so we all need to be able to use those minutes from time to time to stay caught up.
Also, when a patient needs assistance while you are on call, it is very convenient to be able to access your charts so that you are not making decisions blindly.
Use those flow sheets
Those of us managing chronic disease states, such as diabetes, hypertension, hyperlipidemia, or providing primary care often need to review certain screening tests and previous lab values.
For example, you might want to document that your patient has had his/her annual eye exam. You could ask this question each visit, or you could access your handy flow-sheet that documents the date and result of the eye exam, including what follow-up is needed.
This is much easier than going back through many progress notes to find such results. Weight, blood pressure, lipid results, A1Cs, foot exams and more can be documented in these sheets, eliminating time wasted trying to access these results later on.
In a busy office, your fax machines and printers could be continuously cranking out paper, using precious ink, toner, electricity, drums and more. Not to mention the fact that when all that paper is reviewed, it must be scanned by your employees into the chart.
There are ways to reduce the paper tornado by using some special features of your EHR. For example, you could establish an interface with your lab so that patient lab results are directly routed into your charts. They can be reviewed and electronically signed, eliminating the need to print, write on the paper, and then re-scan the paper documents.
In addition, you could use a fax process directly from your EHR system, or better yet, communicate electronically with other providers and healthcare professionals. After all, isn’t our ultimate goal to become virtually paperless?
Improve prescription accuracy and efficiency
Nearly gone are the days of handwritten prescriptions. Most providers have never acquired the talent of excellent penmanship. It is very frustrating to try and read other physicians’ notes and I am sure my colleagues feel the same about me.
Using electronic prescriptions is possible through your EHR. You can also use the drug interaction feature that alerts you to any adverse events.
Still another handy feature is the “curbside consult” ability. This allows providers to obtain a concise summary of a particular drug including indication, dosing, side effects, mechanism of action and more.
Get rewarded for excellent care
Most of us have simple goals in common. We want to provide excellent, efficient care to our patients and remain economically solvent so that we can pay our staff, our bills and our selves.
With reimbursements trending rapidly toward pay for performance, why not take advantage of any incentive money that might be available while we are taking good care of our patients? The fact is, in the not-too-distant future we may be penalized financially if we are not achieving certain health measures or standards of care with our patients.
So for both reasons including acquiring “bonus” money and avoiding “penalties”, an EHR will help you document and provide evidence to those concerned that you are indeed doing an excellent job.
Andrea L. Hayes, MD, FACE, is an endocrinologist in solo practice in Nashville, Tennessee. This article was an honorable mention in the 2014 Medical Economics physician writing contest. Send your technology questions to firstname.lastname@example.org.