Where Does it Hurt? Specialty Physician Shares Three Ways to Improve EHR Charting

The following is a guest article by Jason Handza, DO, Chief Medical Officer at Nextech Systems.

It is no surprise that healthcare providers and other clinical staff want to experience consistent and improved charting capabilities to deliver better patient care. It’s also well known that many physicians remain disappointed with the charting and clinical documentation capabilities of hospital and specialty EHRs.

According to KLAS Research’s Arch Collaborative, physicians want three basic things from their EHRs: strong user mastery, a sense of ownership and system personalization. In KLAS’s latest EHR satisfaction report, response time and reliability were added as foundational factors for EHR success.

However, since each medical service line incorporates unique charting requirements, system personalization and user mastery must rise to the top of these five priority items for physician practices and medical groups. Based on nearly two decades of provider experience with ophthalmology EHRs, here are several tactics physician practices can take to improve ambulatory EHR satisfaction.

Tailor the Charting and Data Review Experience

EHRs organized around the physician’s unique profile, disease specific data sets and specialty workflow remain the most successful in practice. This includes tailored charting and data views based on the EHR’s underlying knowledge database for each specialty.

For charting, ambulatory EHRs should customize the ability to document and view patient data over time based on unique documentation and billing requirements of that practice. This ensures providers view only what they need from the system and don’t get distracted or overwhelmed with unnecessary information. Here are two examples of this requirement from my experience with ophthalmology EHRs: therapeutic injections and medication compliance.

Like many other medical specialties, therapeutic injections are a common procedure done in the office. They have taken over in-office treatments and each type of unique injection requires multiple specific charting and tracking. EHRs should include templates and integrations to support injection documentation, workflows, and increase patient efficiencies. These data elements become even more important for patients that may have anesthesia allergies or intolerance.

Using intravitreal injections as just one example, ophthalmologists must be able to review a patient’s entire therapeutic injection history and easily add or edit treatment and procedure notes in as few clicks as possible. Date of each injection, number of injections, interval of last injection, and visual acuity are common data elements necessary for injection log lists. Expiration date, lot number and other supply information must also be captured. These data elements can be easily accommodated through system integration with supply chain applications.

Medication compliance tracking is another area where physicians closely follow the patients’ data within the EHR to justify more advanced procedures or treatments. In ophthalmology, physicians track patients’ use of eye drops before recommending the next medical intervention. Personalized data views are helpful here as physicians need to quickly view treatment details and patient data at the granular level.

Physicians must also be able to easily see the bigger picture of the patient’s long-term care. Not every provider wants to see every data element. EHRs should be able to serve up only what each specific physician needs from the system.

When system personalization capabilities are available, user mastery quickly follows.

Maintain Charting Mastery Over Time

Health care practices are busy places and EHRs are complicated technologies. System upgrades, staff turnover and changing payer reimbursement rules create the perfect storm for physician inefficiency and knowledge loss over time. Too many specialty EHRs leave physicians feeling abandoned and with no support.

Consistent training and education maintain physicians’ long-term mastery over the EHR. For my practice, ongoing education from the ophthalmology EHR vendor, Nextech, keep staff engaged and productive during the charting process. A dedicated support team with specialty knowledge is another contributing factor for physician satisfaction. Here are four best practices to consider.

  • Pay attention and address staff turnover early and often
  • Support internal trainers since EHR knowledge wanes over time
  • Optimize all software updates that support charting and documentation productivity
  • Make the most of each EHR capability during initial implementation and over time

Rely on the EHR to Stay Compliant

Physician practices need to stay compliant and specialty EHR systems should support them in this endeavor. A focus on compliance is especially important as practices, like ophthalmology, consider future mergers and acquisitions. And since the healthcare regulatory, reporting, and reimbursement environment is constantly evolving, many physician practices struggle to keep up with new rules.

A compliant EHR that incorporates changes for each specialty (and as the physician enters patient data into the system) helps practices limit regulatory shortfalls. For example, ophthalmologists don’t need to keep up with every aspect of the 21st Century Cures ACT, HIPAA Final Rules, or new ICD-10 codes, but their EHR vendors should.

Use a Multi-Pronged Approach to Make Charting Easier

Physician dissatisfaction with EHRs is a long-term problem that our industry must continually try to solve. Physicians want to be in control of their practice and EHR software can help. However, not all EHRs are the same.  Every vendor provides varying levels of specialty knowledge to ensure physician efficiency and productivity.

By taking a closer look at charting, data personalization, training, education, support, and regulatory compliance, all types of physician practices and medical groups can rely more on their EHRs instead of allowing technology to hinder their success.

About Jason Handza, DO

As Nextech System’s Chief Medical Officer, Dr. Handza brings vast experience to this role while working alongside both the Development and Sales teams to improve Nextech’s software offerings. With over 15 years of experience in ophthalmology, Dr. Handza is a Partner at Sight360 in Palm Harbor, FL, as well as Director and Principal Investigator for their Clinical Research Center in Pinellas Park, FL.

   

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