In So Many Words is a timely chat with an ophthalmic industry thought leader.

David A. Goldman, MD, is both the founder of Goldman Eye, in Palm Beach Gardens, Fla., as well as Anterior Segment Team Lead for EHR-developer Modernizing Medicine. There, he learned coding so he could work hand-in-hand with programmers to create the Electronic Medical Assistant (EMA), an EHR by doctors, for doctors.

Ophthalmology Management: How did you end up working for Modernizing Medicine?

David A. Goldman, MD: Around 2012, I decided I would leave academic medicine and start my own practice; I knew EHR was inevitable, so I wanted to start with it from day one of my practice. I tested several, and knew I wanted Modernizing Medicine’s EMA before I even started working with them. Afterward, I heard they were looking for physicians to learn coding. The company is in Boca Raton, close to my Florida practice, and I already had some experience coding. We talked, I liked everything about the job and the relationship just blossomed.

OM: Please discuss your coding experience, and what work have you done for Modernizing Medicine?

DG: I learned early coding languages like Turbo C while growing up. This came in handy for cracking the password on my dad’s computer, so I could play video games — I hacked the login software that had locked me out so I could get in but he couldn’t. At Modernizing Medicine, I did a lot of coding at the start, using XML and JavaScript to add features or fix bugs. It took time to learn, but everyone was patient with me. As the company grew, I’d teach the sales force about ophthalmology, so they could better answer questions from our ophthalmology customers.

OM: What’s the advantage of physicians coding an EHR?

DG: Doctors consider things in a patient visit that a programmer wouldn’t. For example, when I was getting certified on EHR at a large university, their system forced you to click 120 times to get through a patient encounter. There was nothing fluid about it, and it made me understand why most doctors hate EHRs.

OM: How have you helped improve EMA?

DG: I helped convert from ICD-9 coding to ICD-10. During that time, a lot of other software providers used a tool called “Crosswalk” to convert those codes. This was the equivalent of using a pocket translator to speak another language — it’s OK but just isn’t accurate enough for some of the new regulations. For instance, if a chalazion was on the upper lid, lower lid, right eye or left eye, that changes the ICD-10 code completely. I was able to smooth this transition.

I can also put the codes together for new products. Shortly after iStent’s (Glaukos)release, I included the proper medical wording in EMA, which a regular coder might not have known.

OM: Can you discuss Modernizing Medicine’s future?

DG: In September, Modernizing Medicine released its newest program, modmed Kiosk. This iPad app uses a touch-based interface to allow patients to enter their medical information. It’s much simpler and more efficient for ophthalmology patients than online portals.

We’re also paying attention to MIPS (Merit-based Incentive Payment System), which is a growing concern for ophthalmologists. We already have a solid MIPS solution, but the changes are significant for specialty providers, who are very different than primary-care providers. OM