Have you been holding off on investing in an electronic medical records (EMR) system for your ASC? Are you under the impression they take too much time and effort to install and implement? Do you believe your return on investment won’t be sufficient, since the Centers for Medicare and Medicaid Services (CMS) hasn’t incentivized you to implement an EMR?

If your answer to any of these questions is “yes,” Jeffrey Whitman, MD, has an important message for you: “Just take the plunge and get it done.”

Says Dr. Whitman, president of Key-Whitman Eye Center, which operates an ophthalmic ASC in the Dallas-Fort Worth area, “You’re going to be really happy when it’s done.”

Today’s EMR systems go far beyond just relieving the pain and tedium of documenting patient care and reducing the need to store paper-based medial records. They also deliver the added benefits of easier customization, improved patient experience and safety, and greater efficiency, contends Dr. Whitman and other ASC operators.

Benefits of ASC-Specific EMRs

The best EMRs, especially those designed specifically for ophthalmic ASCs, offer a number of advantages over those designed to accommodate multiple specialties. The biggest is their ability to help alleviate the time-consuming task of documenting patient care for both the ASC’s use and for meeting insurance needs, along with CMS, MACRA, and other regulatory requirements.

Streamlined action. “We are a small facility, our procedure times are short, and our patient volume is high. We must be able to move quickly and efficiently, and spend hands-on time with each patient, performing tasks that make them feel comfortable…without spending too much time and attention documenting,” says Patricia Frank, RN, BSN, surgery center administrator at Empire Surgery Center in Bakersfield, CA, which employs Modernizing Medicine’s EMR system, ModMed ASC.

Maya Shammas, MD, surgeon and owner/operator of the Shammas Eye Medical Center and the M/S Surgery Center, which has three locations in Southern California, agrees. “Ophthalmologists tend to rely on high patient volume to maintain profitability,” says Dr. Shammas, whose ASC relies on Compulink’s Ophthalmology Advantage EHR practice management and ASC System. “Also, many ophthalmic surgeries are shorter than other specialties. We have a lot to do and document in a short period of time. A system that can streamline the visit is key.”

Audit-friendly. Ophthalmic-based EMRs can help streamline preparation and completion of state and federal audits, making them very handy in a pinch. “I think some of the largest pain points for me, and I think that probably a lot of ASC directors would say the same thing, is being audited,” says Nikki Hurley, administrator of Key-Whitman’s ASCs, which leverage Eyecare Leaders’ myCare iMedicWare EMR platform.

“With most EMR systems, you have to sit down with the inspectors and go through everything together. I have had three inspections since we started with iMedicWare, and once I showed them what to do, they could look at everything themselves without any help. That means a lot, because it’s hard to spend one-on-one time with the inspectors when they’re looking at your records.”

Easy Customization

With such features as drop-down menus and check-off boxes, today’s ASC-specific EMRs also offer a high degree of customization that caters to the requirements of eye surgery.

“Our needs differ from those of other specialties,” says Dr. Shammas. “An EMR system should be tailored to your specific workflow, because the goal is to improve your efficiency while documenting the patient encounter accurately. A more conventional system will not be able to totally satisfy any one of them.”

Dr. Whitman agrees, noting, “If you had to start from scratch with something that was meant for internal medicine, there would be myriad things you’d have to do (within the software) to bring it to your specialty level. To do all of that for an ophthalmic ASC would be overwhelming.”

To take it one step further, ASC-specific EMRs are also easier to customize to the specific needs of any given ophthalmic surgery center.

“Every ASC will have to build out the EMR system to some extent to match their own needs,” says Hurley. The EMR system used in her ASC provides templates and menus that can be modified for eye drops, medication dosages, and other aspects of eye surgery. “That’s very helpful on the front end. It goes right down the line of everything we need ophthalmically to treat a patient. It’s very nice and organized, and it makes it more efficient,” she says.

Better Patient Experience + Safety

EMR systems that are ophthalmic ASC-specific can also help ensure that patients enjoy a more positive and safer eye surgery experience.

Although they still require clinicians to carefully document each patient encounter, the best EMRs make those tasks more efficient than ever.

“In the operating room, the doctor and the nurses should be caring for the patient and not just clicking buttons,” Dr. Shammas notes. “[With] an ASC-specific EMR, less time is spent in front of the computer so that more of that time can be spent with the patient.”

This enhanced focus on the patient, in turn, leads to greater safety, as many EMRs require certain items to be checked off before the clinician is allowed to proceed further.

“We can build in prompts via required documentation to ensure no steps in the process are ever missed or overlooked,” Frank says. “Also, the ability to import medical conditions, allergies, and current medications directly from the clinic or patient pharmacy provides less chance for clerical human error that could be severely detrimental to the patients we care for.”

“When I look into the EMR, I can clearly see everything that is pertinent on just one or two tabs. I don’t have to click multiple tabs to know critical patient information,” says Dr. Shammas. “And when the ASC is connected to the office chart and information can be forwarded back and forth, there is less room for transcription errors.”

Why Don’t More ASCs Use EMRs?

Despite all the benefits associated with ASC-specific EMRs, relatively few ophthalmic ASCs, compared with medical practices, have adopted them.

One major reason, Hurley believes, is that CMS hasn’t offered ASCs the same financial incentives to implementing EMRs that they have offered medical practices. In fact, ASCs are viewed as extensions of medical practices.

“As with clinics, there weren’t any incentives from CMS for ASCs to implement EMRs, so a lot of ASCs haven’t wanted to purchase and build out a system,” she says. Another reason, she adds, could simply be the ASC’s reluctance to change.

“We’ve had to change systems along the way, and we have had some kicking and screaming,” adds Dr. Whitman. “But if you ask me now if we’re better for having an EMR system or better for not having it, we are definitely better for having it.” ■