ModMed’s electronic health record software provides specialty-specific solutions to help ophthalmic ASCs maximize their workflow.

Cataract surgery volume is poised for continued growth over the next decade, so ophthalmic ambulatory surgery centers (ASCs) must find ways to keep their case flow streamlined without negatively impacting the patient experience. Adopting an electronic health record (EHR) system is one way that ASCs can boost their efficiency. Although recent surveys indicate that ASCs continue to lag in the adoption of EHR systems, growing numbers of administrators believe now is the time to make the leap to an electronic system.

But making a switch can be daunting. Kasey Gantz, administrator for Alliance Vision Institute in Fort Worth, Texas, says that the fast-paced nature of ophthalmic surgery makes it difficult to consider trying something new. “You get used to working on paper,” she says. “It’s something you can control, right in front of you and it’s hard to think about going through the learning curve of doing things a new way.”

Still, Gantz and her team recognized that paper had many shortcomings and with patient volume growing, they needed to remain efficient both in the clinic setting and the ASC. Alliance Vision partnered with Modernizing Medicine’s EHR system, ModMed EMA, to implement changes in both settings. The clinic was brought online first, followed by the ASC. ModMed EMA’s ophthalmology software digitizes the workflow to streamline operative reports, nursing notes, state reporting, and other necessary documentation.

“In the ASC, anesthesia was initially hesitant to adopt, as happens in a lot of ASCs,” Gantz recalls. “Their involvement in each case is very quick, very efficient on paper, and they have a few steps to take, so the initial perception can be that electronic charting is a less efficient workflow. But we got them onboard with trying it and now our entire ASC is electronic—and everyone loves it.”

Gantz says that efficiency has been improved and any fears that administrators had about taking away from the patient experience have been disproved. “I think we were concerned with limiting our personalized patient approach while using the computer, but the system works so intuitively, there is little disruption in that aspect and it has learned our dynamics,” she says. “The software does not replace clinical decision-making in any way, but it knows, for instance, that if we have charted a particular service to suggest the codes that could be assigned. It keeps everything moving along without taking away from the patient interaction.”

A CUSTOMIZED SOLUTION

Hesitancy about EHR adoption was similar at Eye 35 ASC in Schertz, Texas, says clinical director Carson McCafferty, MSN, RN, CNOR, CNAMB, CSRN. Being a fast-paced ASC, the idea of electronic charting was “scary,” she admits. But ModMed helped customize a platform designed for their needs.

One of the things that drew Eye 35 ASC to ModMed in the first place was the ability for customization. The software allows the user to customize sections, make fields required or optional, set default responses, and change the order, layout, and format to best suit the practice’s flow. “It was narrowed down to what we do and what we need, and it actually made our charting more efficient,” says McCafferty. “Even our doctors remarked that the ModMed EHR did not slow us down in any way.”

McCafferty likes that it makes the charts neater and more organized. When staff needs to find something, they know exactly where to look, she says. If the ASC is being surveyed for accreditation purposes, for instance, the software provides the data in an organized and efficient way.

“From a surgeon’s perspective, they like not having to manually sign so many documents,” she adds. “They can just click a button. If we need to find a record quickly, we can pull it, scan it, and send it. Everything is so streamlined.”

Gantz agrees that in addition to streamlined charting at their ASC, “life is easier on the administrative and business sides, too.”

“We are able to complete charts by the end of the day and send financial charges over to the practice side for completion and claim submission,” Gantz continues. “For example, we’re doing surgery today and will do 40 cases. All 40 of those charts will be completed at the end of the business day. This allows for a very small window of time between date of service and date of claim submission. This approach in efficiency is extremely valuable to the revenue cycle of the ASC.”

MEETING THE GROWING VOLUME

Michael B. Rivers, MD, the director of ophthalmology at ModMed, says that efficiency is the name of the game right now, due to the growing demand for cataract surgeries and other ophthalmic procedures combined with reimbursement cuts.

“I met with a practice that has seen their surgical volume increase by 20 percent—and the national trend is that cataract surgery will increase by 4 to 7 percent each year,” Dr. Rivers says. “So, becoming more efficient is critical. ASCs need to figure out how they can improve their clinical workflow.”

Dr. Rivers says that the workflow process begins in the clinic, where patients are first seen for a consultation before having their surgery scheduled. “The challenge in delivering software is that we are talking about two different groups—the clinic side and the ASC side,” he explains. “The clinic is already using software, but we can help them fine-tune their workflows. And then we do capture data in our ASC platform that needs to get pushed back to them for billing. So, there’s an important need for everything to work together.”

Every situation is a bit different, which is why ModMed is so focused on customization. That is especially true for the workflow. Ophthalmologists are a very diverse group, so the ModMed software provides different ways to document patient visits. A retinal specialist may want to use one feature, a cornea specialist may want to use a different feature, and an optometrist may want to focus on a completely different part of the patient exam.

“At ModMed, we recognized that diversity and created different areas within the workflow to document the unique features of their subspecialty,” says Dr. Rivers. “We do not come in and force a new workflow. We have a training team that understands that every ASC has a different workflow, and we need to build our system around them. As an ophthalmologist myself, I know that there is a lot of pressure on doctors in the ASC, and we are working to make that better. Improving the efficiencies and the workflow in the ASC is the driving factor of our software.” ■