Effective electronic medical record system boosts efficiency

When Joseph L. Sokol, MD, decided to break out on his own about a year ago, one of his first major decisions was choosing an electronic medical record (EMR) company.

"I felt that electronic records were the wave of the future," said Dr. Sokol, of Connecticut Eye Specialists, Shelton, CT. "I thought if I could start the practice fresh with electronic records, it would be easy and save me down the road."

This paperless system-also known as an electronic health record (EHR)-ties together online medical and ophthalmic history, vision examination, and all ophthalmic testing. Patient information is accessible from any location.

"I don't know that it makes me faster, but it enables me to work efficiently and produce . . . a better record of the visit," said Dr. Sokol, who admitted he sometimes couldn't read his own writing on paper charts. "This gives me a neat and reproducible [record] to print out for a doctor or patient, or for me to refer to.

"It enables me to communicate with referring physicians better," he said. "It's compact and legible. I can use it to write letters to go back to referring doctors almost immediately about a patient's treatment plan. It's made me a better communicator."

Discovering efficiencies

Debbie Weiss, an administrator with Dallas Eye Care Associates, said her practice adopted an EMR program from a California-based practice management software developer (Compulink Business Systems) in October 2008. Implementing an EMR system has created a number of efficiencies in Weiss' office, including less paper, less personnel, and increased patient satisfaction.

"Patients love it. They feel like they're in the right spot because of the technology," she said.

Weiss echoed Dr. Sokol's advice to seek out an EMR company with experience in optometry and ophthalmology. She was able to set up the program with the physicians' specifications, creating simple forms that ensure no information is missed during a visit.

"I call it 'teching for dummies,' " Weiss said. "Everything on that page is what is required."

Avoiding EMR failure

James Silone, DO, with Center for Sight in Newark, OH, offers three pointers on how to avoid EMR failure. A practice needs:

"If you let the office manager or staff member do all of this and you're just trying to learn, it's a much more difficult process," Dr. Silone said. "If you're involved and show you're interested and taking a leadership aspect, the whole transition is much smoother."

Dr. Silone, who spoke about preventing EHR failure at the recent annual meeting of the American Academy of Ophthalmology, said it took 3 months for his three-partner practice to become comfortable with the system. One of the biggest challenges was breaking the habit of writing everything down instead of typing it into a computer.

Adopting an EMR system also has forced Dr. Silone's practice to look at employee hiring in a different way.

"We used to look for good handwriting. Now we look for good typing skills," he said.

Dr. Sokol said adopting an EMR system allows him to keep better track of patients, including keeping tabs on visual fields, checking glasses, and using a surgical database for clinical trials.

"With a couple of keystrokes I can figure out what testing I've done, what needs to be done, and if there are any problems," he said. "It's just a better way to practice medicine."

Weiss said her EMR system has cut printing costs by 36% in 1 year. It also cut down on faxes to the group's satellite office in Gun Barrel, TX. With EMR, physicians at the satellite office can consult on patients and review records online.

"I'm a paper Nazi," she said. "If I see someone using paper, I question them on it."

Weiss' office also is using EMR for Web registrations. New patients can view information about the practice online and also are directed to the Web site to fill out family medical histories and list their medications. The process streamlines the office visit, meaning technicians are free to perform other duties, physicians can spend more time talking about patients' concerns, and waiting rooms aren't overflowing.

"The front office punches a button and it feeds into the medical records," Weiss said. "It saves staff time because the patient has done part of that work. I'm trying to find ways to save time because we'll only see more patients in the future with the Baby Boomers. I'm trying to find ways to see more patients in less time."