EMR software helps practices retain patients and manage medications

Wireless technologies will offer unfettered access to medical records and enable patients to make appointments online.

Electronic medical records are gradually changing the way practices store, retrieve and use vital information to boost efficiency and ramp up the quality of care.

Software built into EMRs or used in conjunction with such systems enhances practice management functions in a myriad of ways. Software products enable practices to prescribe medications, make office appointments and recall delinquent patients more efficiently than does a paper-based system.

Also, wireless technology will soon allow patients, physicians and staff to access EMRs from any Internet connection via personal computers, laptop computers and handheld wireless devices.

“We are putting our electronic medical records out on a cloud,” Sara Rapuano, MBA, OCS, administrator for Corneal Associates at Wills Eye Institute in Philadelphia, said. “We will be able to access that cloud from any Internet connection, allowing physicians to access medical records from any office location.”

Add-on patient recall software

Care quality hinges largely on how well practices retain patients. Software built into EMRs and used in conjunction with these systems helps practices contact delinquent patients and make appointments for long-belated care.

Debbie Weiss, administrator at Dallas Eye Care Associates, said her practice uses the Brevium patient reactivation software package, which provides practical tools for contacting patients who have missed office appointments. Staff use Brevium as an add-on to Compulink’s Ophthalmology Advantage EMR system, which also has a built-in patient recall function. Dallas Eye Care Associates adopted Brevium in June.

“It is a wonderful way to reactivate patients,” Ms. Weiss said.

Because the staff make the telephone calls, they can stress the importance of the exam and patients can be educated about eye conditions and diseases. The personal contact is much better than a card or letter, she said, because the staff have a better understanding of glaucoma or diabetes, for example, and can talk to patients about the importance of returning for their eye care.

Brevium also lets staff keep meticulous records of patient adherence to scheduled appointments.

“I can run a report at the end of the month,” Ms. Weiss said. “I can see how many patients each staff member has called. I can see how many appointments they made, and I can see how many patients kept those appointments.”

In one 3-month period, Dallas Eye Care Associates reactivated about 960 patients using Brevium.

Built-in recall function

The cornea department at Wills Eye Institute uses a proprietary patient recall system built into the NextGen EMR. This tool is used to set up patient recall plans that can be tailored to the needs of an individual practice.

“That recall plan triggers a letter that goes out to the patient,” Ms. Rapuano said. “If they have not already made an appointment, they will receive a letter a couple months before they are due for that appointment. You can run reports that basically tell you if all recalls have made their appointments and come in.”

Wills Eye Institute plans to create patient portals through which patients can make appointments online and potentially access their medical information online. Offices would also be able to send recall e-mails through this system, but the system would still allow the user to print and send letters to patients who do not use e-mail. The demographics of the department would determine whether recalls are made via e-mail or print. Particularly in ophthalmology, many patients are older and may not want to receive e-mails. The patients will make the choice, Ms. Rapuano said.

Web interface between practices and patients is mandated by the Centers for Medicare and Medicaid Services’ meaningful use regulations for EMRs. Practices must meet meaningful use criteria in order to qualify for financial incentives and bonuses tied to EMR implementation. The meaningful use regulations are scheduled to take effect in January.

Safe and seamless prescribing

Electronic prescribing functions are integral to many EMR systems. Dallas Eye Care Associates uses the NewCrop electronic prescribing service in conjunction with the practice management function of the Compulink Ophthalmology Advantage EMR.

Wills Eye Institute uses NextGen EMR’s built-in e-prescribing function to access SureScripts, the largest e-prescribing network in the U.S. The system allows practice staff to base prescriptions on a patient’s full medical and medication histories, Ms. Rapuano said.

The system flags potentially catastrophic drug interactions, providing another layer of protection. If the patient has given a full medical history, when a new medication is prescribed, the physician is alerted to any potential interactions with the patient’s existing medications, Ms. Rapuano said. In addition, the SureScripts network generates messages regarding interactions with other medications.

NextGen EMR’s e-prescribing software also includes a function that allows a practice to automatically transmit the billing prescription code to Medicare in order to get a Medicare e-prescribing bonus, Ms. Rapuano said.

“We have been submitting that code for 2 years now and we have received our bonus payment from Medicare,” she said. “It is a nice extra payment when you get it and it is as simple as transmitting one additional code along with the visit codes.”

Health information exchanges

Health information exchanges, or local, regional or national databases, help patients and clinicians share information.

“At Wills, the need for health information exchange is huge because a lot of patients come here and see a number of our subspecialists,” Ms. Rapuano said. “That is why they come to Wills.”

CMS is still ironing out many details of meaningful use, particularly criteria for the creation of health information exchanges, Ms. Rapuano said.

“The health information exchange is really the big question out there,” she said. “What information can we start exchanging with other doctors so that we have a full medical history? The subspecialties at Wills have not been integrated yet. That is the next step. That is really where we are going to benefit from the use of EMRs.” – by Matt Hasson

• Sara Rapuano, MBA, OCS, can be reached at Corneal Associates, P.C., Wills Eye Institute, 840 Walnut St., Philadelphia, PA 19107; 215-928-3174; e-mail: sbrapuano@yahoo.com.
• Debbie Weiss can be reached at Dallas Eye Care Associates, 5494 Glen Lakes Drive, Dallas, TX 75231; 214-692-8220; fax: 214-692-8764; e-mail: decaeye@aol.com.