The Path to Paperless

Best Practices from Top Practices

Transitioning to EMR? Here's good advice.

By Peter J. Polack, MD, FACS

Our practice is a member of the Large Practice Interest Group (LPIG), created by John Pinto, a leading ophthalmic practice management consultant. It is a work-group of about 18 practices of similar size and revenue, which meets once a year to discuss a variety of issues related to practice management.

At our recent meeting, I had the opportunity to ask physicians and administrators of LPIG for their words of advice regarding EMR and medical practice IT. Why are their views so important? Because these larger practices thrive on economies of scale. They tend to be the early adopters in technologies that promise efficiency and cost savings.

Their first major caveat: beware of EMR software companies that are "just now getting into the ophthalmology EMR arena." With meaningful use deadlines looming in the next year or so, now is not the time to be a guinea pig for a company testing the waters with their new product. An EMR system for any specialty, but especially one as unique and complex as ophthalmology, requires a robust knowledge base, and a company with little or no experience will end up relying on you, the customer, to help them build their product.

Garbage In Equals Garbage Out

Next piece of good advice: don't skimp on training when it comes to your EMR system, as your employees are likely to input incorrect data or enter the correct data into the wrong place. If you have ever seen someone save a file in the wrong place and then try to find it again, you can only imagine the chaos caused by huge amounts of patient clinical or financial information stored incorrectly.

Do Your Research on Imaging Systems

It was only a few years ago that ophthalmology practices had few options when it came to imaging systems for viewing everything from fundus photos to visual fields. But now there are more choices — some integrated with the photographic equipment and some stand-alone systems.

Make sure that any imaging systems that you are interested in purchasing are compatible with your EMR system, are user-friendly and are able to generate high-resolution images across multiple locations without tying up excessive bandwidth.

A scanning solution can make a good transitional tool. If you are overwhelmed with the volume of paper records but haven't yet acquired an EMR system, a scanning solution can be a great stopgap measure. But realize that it will not qualify for meaningful use incentives. It is simply a way of getting by until you have decided on an EMR system.

Issues With Integrated EPM/EMR Platforms

I have also mentioned this in previous columns. Although software companies are getting better about "playing nice" with others, if you use different vendors for practice management and electronic medical records systems and there is a compatibility issue, each side will point fingers at the other and you will be the one left holding the bag.

If you do opt to use different EPM and EMR systems, make sure you synchronize upgrades. If both systems are working well together and it's time for the one system to get its latest upgrade, this can potentially create problems with the other system. The best advice is to get both companies' reps talking together on a conference call and plan the upgrades to avoid any problems. OM

Peter J. Polack, MD, FACS, is co-managing partner for Ocala Eye, a multisubspecialty ophthalmology practice located in Ocala, Fla. He is also founder of Emedikon, an online practice management resource for physicians and administrators.