Modification to EHR program helps physicians monitor glaucoma patients

In part seven of a series from the OSN Technology and Equipment Workshop featured at Hawaiian Eye 2010, Jeffrey V. Winston, MD, discussed how Compulink’s Ophthalmology Advantage electronic health record system can be modified to monitor glaucoma progression more effectively.

Ophthalmology Advantage is a comprehensive electronic health record and practice management program designed specifically for ophthalmic practices. In general, the goal of EHR systems is to reduce paperwork so physicians can focus their time on diagnosing and treating patients.

Dr. Winston has taken the program one step further by altering screen displays, adding automatic testing and developing his own glaucoma summary tab to better serve the needs of his glaucoma patients.

“I want to display as much information on one screen as I can,” he said. “I want to be able to absorb the information, identify if they had previous surgery, find out what medications they are on, look at their optic nerve, look at their visual field and look at their last retinal nerve fiber layer.”

Provides more interaction

While Ophthalmology Advantage comes equipped with a customizable patient summary screen, Dr. Winston’s self-designed glaucoma tab allows him to quickly determine the severity and progression rate of his patients’ conditions. He can view everything from their visual acuity to their glaucoma subtype; their pressures on the last 10 visits to their last five visual field tests; as well as his last assessment and treatment plan.

“If you spend too little time evaluating the patient records, you can miss some important information,” he said. “In the old paper charts we used during my residency, you could spend five minutes going through the last 30 pages looking for something important.”

Dr. Winston, who now serves on Compulink’s advisory committee, credits the program with allowing him more face time with his patients. Instead of having to analyze a chart before he greets a patient, Dr. Winston said he appreciates the ability to go into an exam room already knowing the patient’s history.

“I can get some eye contact and start a rapport. Before I [designed the glaucoma screen], I couldn’t even say anything to the patient until I looked at the chart for a little while,” he said.

Simplifies prescriptions

Ophthalmology Advantage also helps physicians keep track of medications, especially in relation to a patient’s IOP. According to Dr. Winston, the program can generate graphs that show pressure vs. time, a list of current and past medications, and any previous testing. This feature helps to quickly determine whether target pressures are being met and what further tests are needed.

Physicians can also save time by using the program’s optional electronic prescription feature. E-Rx streamlines the renewal process by automatically sending patient information to the pharmacy.

“The feature offers increased accuracy and less confusion by the pharmacy because it is more legible,” Dr. Winston said.

The future of EHR systems

While most EHR systems include customizable elements, Dr. Winston believes better displays will lead to highly automated programs that users can tailor to their practice’s individual standards of patient care.

“They will be like traffic controllers, where lights will be different colors to signify if something is abnormal or normal,” he said. “They will have logic to remind you what test to perform based on your practice guidelines and what you’ve developed through your office.”

Dr. Winston is confident that in the long run, EHR systems will lower health care costs and improve the quality of care.” – by Courtney Preston

• Jeffrey V. Winston, MD, can be reached at La Mirada Eye and Laser Center, 12675 La Mirada Blvd., Suite 301, La Mirada, CA 90638; 562-204-3003; e-mail: jvwinston@winstonmd.com. Dr. Winston is a member of the Compulink Advisory Committee and has used the product for 11 years. He is not a paid consultant.