Thinking of trading your paper files for a data pad or keyboard? Or are you looking to upgrade to a system with more robust capabilities — one that’s easier to use or just a better fit for the way you work?
Many physician practices and hospitals have gone to paperless offices and say it saves time, helps them increase reimbursement and even gives them tools to work more effectively. But there are a number of points to consider before choosing a system that will work well for you.
Here’s the inside story from three Alabama-based information technology vendors who specialize in healthcare.
Carrie Gulledge is a registered health information administrator (RHIA) for MediSYS of Birmingham. The company customizes the Encite Electronic Healthcare Records system and the M2 Practice Management system for physicians’ offices. It also offers online data hosting and outsource billing services.
Matt Price is vice president of sales for Oceris, Inc., of Huntsville. Specializing in individual and group practice systems for physicians’ offices, the company is a vendor for FlexMedical Electronic Medical Records Systems, Flex E & M Coding and integrated digital office systems.
Jose Antonio Valencia, president and CEO of The Valencia Group, helped to launch one of Alabama’s first paperless hospital registration, medical records and business office systems before opening his own company. His Birmingham-based firm creates specialized solutions for healthcare finance management for hospitals across the state, and provides total business office outsourcing for two hospitals.
Gulledge: “One of the first things physicians notice is not having to miss their children’s ballgames because they had to work late. Their documentation is complete when they leave the exam room. In billing, if the practice has been undercoding due to lack of documentation, they could see an increase in revenue. Look for a system that calculates the level of service and gives you the appropriate code based on supporting documentation.”
Price: “An average paper chart costs $8 per year to maintain, but electronic charts cost only around $2. The physician and staff save a tremendous amount of time. Saving five minutes documenting each visit, multiplied by 25 appointments per day would save a physician two hours a day. The physician can see more patients per day, and the practice can grow without having to add staff. You can also eliminate or reduce dictation and transcription.”
Valencia: “In the hospital setting, electronic medical records organize the work electronically and allow more efficient and effective use of resources. Multiple users can access records with better security, and systems can be set up to allow physicians to code and review records remotely. There are savings from eliminating file room space, reallocating staff time and other efficiencies in addition to the financial advantages of improved cash flow and documentation for appropriate reimbursement.”
What types of systems are there?
Price: “Integrated multiple vendors with one providing software and others providing equipment give you a wider choice of features, but you need a clear understanding of who to call for support. An integrated single vendor can provide support on both software and service, but you should make sure the system has all the capabilities you need. Another possibility is a software subscription service that lets you work online and store data on an off-site server. If you have slow or unreliable Internet service, however, you might not always be able to access your system.”
How can you make sure your system is well matched to your needs?
Gulledge: “We start by looking at what a practice is doing now so we can identify the types of documentation and functions they need and the language they use. Then we customize the service, let clients actually use each version, and we refine the system based on their feedback.”
Price: “Flexibility is important. Templates make it convenient to quickly click on what you need, but they should also be customized to your specialty and the way you work. For example, do you need the ability to add notes? Also, think about other ways you might want to use the information. If you’re set up for data mining, you can see which patients are on a specific medication, or generate postcard reminders for patients who need to come in for periodic testing.”
Valencia: “We start with a process analysis to determine the features that a hospital may need based on its goals. It can be 100% customizable. We have templates, but we review processes and customize as needed for better data integrity, better patient relations, increased cash flow and better management of accounts receivable and other objectives.”
What kind of equipment is necessary?
Gulledge: “You’ll need workstations for your staff, and preferably a high-speed scanner to in-put paper documents you receive. The physician will need a way to in-put information during exams, which can be a keyboard or data pad. You also need to be able to send and receive faxes and other messages. If you choose to have your server onsite, you’ll also need to be able to backup data to DVDs or tape.”
Price: “You may want a server to keep your files on site. It’s also important for physicians to consider how they and their patients will be most comfortable using the system. If you’re accustomed to keyboards, a laptop or workstation is fine, but be sure to position it so you can maintain eye contact with patients. Custom templates and a personal data pad can be a convenient choice. It’s about the size of a chart. If you need to add notes, look for that option. Handwriting recognition and voice recognition are possibilities, but the technology may not be as advanced as you need it yet.”
Valencia: “We interface with the hospital’s system and look at necessary upgrades during the analysis. Our systems are scalable and can integrate with any recognizable hospital information system to handle registration, medical records, audit, utilization review, business office and management in general, in addition to documenting patient care.”
What’s the best strategy for actually implementing the transition from paper to digital?
Gulledge: “We work closely with practice administrators and office managers to formulate a plan for training and for getting paper records into the system. In addition to telephone support, you can set your system up so we can check for problems online.”
Price: “Get the staff on board and have a plan for scanning paper records, possibly as you pull them for each appointment. Plan time for training, and make sure you have access to follow-up training and support later.”
Valencia: “Paper processes are just that, processes that support paper and not digital processes. We recommend re-engineering the processes prior to deploying technology. It’s important to choose knowledgeable people you can rely on and with whom you can build a good working relationship during transition and over the long term.”
Any other advice?
Price: “Ask questions. Ask for references. Talk to people who are already using the system.”
Valencia: “In addition to experienced trainers and support staff, look for a vendor who is knowledgeable of medical industry rules and regulations and who stays up to date.”
Gulledge: “Be prepared for paper withdrawal. It takes a few days to get comfortable. After a while, people usually say, ‘I can’t believe how easy this is to use.’ It’s a bit like plastic surgery. At first, you wonder ‘What have I done?’ Then, when you see the final results, you look back and say, ‘Why didn’t I do this sooner?’”
September 2007
