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Maximizing the full potential of EHR in a dermatology practice
As dermatologists shift to implementing cloud-based electronic health records, a major complaint is how to properly and swiftly train office staff, in addition to utilizing the technology to its fullest potential.
Kelly Poole, BSN, RN, director of clinical operations at Schweiger Dermatology, spoke with Healio Dermatology about her firsthand experience on the frontlines of implementation of an EHR system across 40 of Schweiger’s practices.
Read on to learn about how implementing the technology streamlined cross-practice communication and information sharing and also for Poole’s tips on training staff.
In what ways has implementing EHR shaped your practice and patient care?
Poole: In short, it has made us more efficient across all our locations and has saved us time to focus more on our patients. Our practice, Schweiger Dermatology, has more than 50 locations and 150 providers, and we are one of the fastest-growing dermatology practices in the Northeast. Our EHR technology has shaped our practice and approach to patient care by functioning as a reliable, helping hand for our team throughout our rapid growth. It helps ensure that documentation remains streamlined, while decreasing the administrative burden on our providers and office staff. We eventually switched all our offices over to Modernizing Medicine’s EHR, EMA, due to its intuitive, user-friendly and customizable nature. Our providers have been able to easily customize the platform to meet their individual needs, allowing them to spend less time tweaking information during the flow of the exam or after hours and more time focusing on patients.
Additionally, the EHR system has streamlined data collection along with coding and billing reporting, which means we have more time to concentrate on the needs of our doctors and patients. For example, our previous EHR required a tremendous amount of work building templates and entering dermatology billing codes. Our current EHR, however, uses adaptive learning and automatically suggests ICD-10 codes. Our insurance claim denials have also decreased from 9.25% to 6% since implementing our new EHR. Not only that, but because the solution is user friendly and comprehensive, our providers are saving hours in documentation time as well. At the end of the day, our EHR helps alleviate the burden of repetitive, tedious tasks while remaining ahead of the curve amidst all the reporting changes we are facing now and will in the future.
How can providers be sure they are getting the most out of the technology?
Poole: Spend time upfront to learn about the capabilities of your EHR platform and how you can customize it to meet individual needs. Because we have hundreds of providers and continue to experience exponential growth, everyone wanted something different in order to make their workflow easier. As I mentioned, our providers have been able to customize our current EHR so that the platform offers up their most common plans and diagnoses, and the various screens follow their preferred workflow during an exam. Because they feel the notes in EMA are easier to create and close in a timely manner compared with our previous system, they can make sure they are prioritizing the patient during an appointment rather than the documentation.
To help ensure our team was using our EHR system to its fullest potential, we attended multiple workshops and training sessions, which I think is of critical importance in order to properly onboard and put your practice on a successful path.
What are your best practices for training and implementation?
Poole: Staff buy-in along with training and implementation are crucial when making the switch to a new EHR. You want to make sure providers and office staff are getting the most out of the solution. To kick off our training process, we created an in-depth project plan outlining all the necessary steps and tasks needed to prepare for the transition. Then, we grouped a handful of our 50+ office locations together to create an implementation taskforce. Next, we closed the selected offices and brought them to one central location for a 48-hour workshop. At first, we did this with three offices at a time, but everything went so smoothly that we decided to do five or six offices all at once — our largest workshop was about 60 staff members.
Having a dedicated team and setting aside the time to work with our EHR provider and immerse ourselves in the technology proved invaluable to our success. After the workshops wrapped up, our providers and staff went back to work as normal, using the previous EHR system for 1 more week before going live. During this first week, our providers also had a reduced patient schedule so they could focus on learning the system. It only took about 1 week for the majority of our providers to get back to a normal schedule.
Now, the training process for new employees is seamless. We attribute this to the time we dedicated to learning about the technology and working with our system provider upfront. Now, it is like we can implement this tool at our new locations with our eyes closed.
What criteria should physicians use to find the best EHR system to meet their needs?
Poole: We first learned about our current EHR when we acquired a few practices that were already using the solution. The providers using EMA were so loyal to the software that we allowed them to continue using it, and eventually, after evaluating system performance against our previous EHR, we decided to transition all our other offices to this technology as well. We had an advantage during selection because we had familiarity with the EHR we chose. However, I think it is important for physicians going through the selection process to speak with other users of solutions being considered to hear firsthand how it works.
Choosing a dermatology-specific EHR system is also something I would highly suggest practices consider as part of their main selection criteria. We attribute the dermatology-specific billing codes and workflows that came out-of-the-box with our EHR as our biggest time saver.
Opt for a trusted EHR provider that will be with you throughout the whole implementation process and feel like an extension of your team. Whenever one of our providers has a question about the functionality of the technology that our extended staff cannot answer, our current system provider is there to help, plus they have a robust library of webinars and how-to guides. We know that the needs of our staff are going to evolve in the future based on changing regulations, best practices and industry standards, so it was important to know that we invested in a vendor that was committed to staying ahead of the curve. I would say aiming to find a technology company that will act as a true collaborator in this process, rather than just a vendor, is critical. It is all about relationships.
What were some of your greatest challenges throughout implementation?
Poole: The challenges we encountered along the way were minimal and to be expected. There was some resistance from employees who were accustomed to our previous EHR technology and a few learning curves along the way. That being said, the implementation process was a lot smoother than we had dared to hope. I think our focus on preparation for our official launch and implementation made all the difference.
Is there anything else that dermatologists should know about using EHR?
Poole: Don’t underestimate the importance of cloud. Since implementing our cloud-based EHR, we have experienced a significant increase in efficiency/speed, and our providers can access patient records from anywhere. A true cloud-based system is necessary with multiple offices and our continued growth.
We also recently began using a patient engagement tool called modmed Kiosk from the same provider so patients can fill out their paperwork using an iPad at check-in. This functionality has proven to be a time saver, saving the medical assistants from collecting the data themselves. It has helped us to elevate our customer service and focus on our patients.
Disclosure: Poole reports she is employed by Schweiger Dermatology.