EMRs and adjunct IT programs boost efficiency, improve communication

Billing software, patient portals and clinical image retrieval packages enhance office workflow and patient care, experts say.

Laurie K. Brown

Electronic medical records are designed to enhance patient care and reduce costs. In addition, other health information technologies may complement EMRs, further improving the efficiency of business and clinical operations.

Some EMRs, also known as electronic health records, ensure patient privacy and security and, in some cases, can be used to electronically prescribe medications. Add-on software packages — used alone or combined with EMRs — streamline other vital functions such as scheduling and billing, improve physician-patient communication and speed diagnosis, according to two users who are familiar with these systems.

Laurie K. Brown, COMT, COE, OCS, practice administrator at Drs. Fine, Hoffman and Packer in Eugene, Ore., and retina specialist Peter Win, MD, of Pasadena, Calif., discussed practice management and clinical image retrieval systems used alone and in conjunction with EMRs.

Ms. Brown said her practice is about to launch General Electric’s Centricity electronic data interchange (EDI) services, an add-on to the popular Centricity EMR that is designed to handle electronic billing, Medicare eligibility certification, claims status inquiry and other key practice management functions.

“It’s something that allows practice growth without increasing staff-related costs,” Ms. Brown said. “It will allow us to perform and be reimbursed at a higher level of efficiency. The data entry and throughput of patients in the office is more efficient because of all the things that you can do online instead of on the phone.”

EDI offers concise, centralized billing information and helps to reduce time-consuming telephone conversations, she said.

“It’s all very timely and electronic. You no longer have long, inefficient phone calls in advance of patient appointments or while patients are waiting for minor procedures, so that you can check their eligibility,” Ms. Brown said. “It gives you snapshots of all activity going on with claims, including key billing performance indicators in your practice. When you use something like this, you have one clearinghouse to manage, instead of many clearinghouses. It centralizes everything.”

EDI’s only downside is its cost, but improved efficiency may justify that cost.

“The only con that we can really think of is that it might be a new expense for practices,” Ms. Brown said. “But everything’s moving electronically, and that’s what’s most efficient. So it’s sort of inevitable.”

Also, Ms. Brown said Kryptiq is a patient portal service that can be used as an adjunct to an EMR or accessed online through a third-party vendor.

“This gives you the ability to provide online health services for your patients, to provide customer-centered care by improving their information access to you, rather than having phone calls going on,” she said.

Kryptiq and other secure online patient portals let patients register, enter their medical histories and convey other information on their own time.

“We feel that this has reduced phone calls and incoming paperwork for our practice,” Ms. Brown said. “It’s always easier to communicate with people by e-mail. They can answer when they want to. With portal services, you also minimize redundant data entry.”

Imaging retrieval aids diagnosis

Dr. Win’s practice uses the NextGen EMR to electronically link its main office to several remote offices. Physicians can access the EMR from remote office sites or from their homes via the Internet, Dr. Win said.

“It’s really convenient,” he said. “It’s great for patient care, for patients calling, even when we’re at home. When I don’t remember the patient or exactly what was done, I can simply log into my computer while I have the patient on the line, and I can update myself about the patient. Having this resource available enables me to provide better patient care.”

In their offices, staff members use the Symphony Image Management system (Ophthalmic Imaging Systems) to retrieve retinal optical coherence tomography images in each examining room, Dr. Win said. The Symphony is neither Web-based nor connected to the NextGen EMR.

“This program allows the doctors to analyze and compare the before and after OCT images in the examining rooms right in front of the patients,” he said. “It’s really efficient, not just for the doctor in terms of speed and taking care of the patients. It also helps us in educating the patients. They understand what we’re dealing with, and they become part of the team in monitoring and treating the retinal disease.”

Calls for more interoperability

EMRs and other electronic medical technologies have not reached their full potential. Ms. Brown said there is a lack of interface between testing equipment and EMRs, and Dr. Win cited the inability to connect clinical images with numerical data in an EMR.

“The high desire of ophthalmic testing equipment manufacturers to integrate with EMR software doesn’t seem matched by the EMR manufacturers’ motivation in most cases, perhaps due to their desire to protect their proprietary technology,” Ms. Brown said.

Dr. Win said he would like a software that marries clinical images and numeric data into an EMR for easy retrieval and timely, thorough analysis.

“It would be nice if we could have a program that’s integrated, where within your electronic medical records, you can type in all the information and at the same time see the images connected into one program,” he said. “I think that’s ideal, but from a logistics standpoint, I think it’s really hard.” – by Matt Hasson

• Laurie K. Brown, COMT, COE, OCS, can be reached at Drs. Fine, Hoffman & Packer, LLC, 1550 Oak St., Suite 5, Eugene, OR 96401; 541-687-2110; fax: 541-484-3883; e-mail: lkbrown@finemd.com.
• Peter Win, MD, can be reached at Retina Institute of California, 800 S. Fairmount Ave., Suite 312, Pasadena, CA 91105; 626-568-8838; fax: 626-583-8838; e-mail: phwin1@yahoo.com.