As technology improves and healthcare reform rolls along, many physicians and practice managers are asking their medical billing companies for advice on electronic record systems.
Some practices are moving from paper to digital; others are unhappy with their current system and want to upgrade. Most know that they want their patient records to work well with other systems including billing. And some medical billing companies are starting to offer clients a free electronic record system in exchange for their billing business.
Often, the first question physicians and practice managers have is, “What’s the difference between electronic medical record (EMR) and electronic health record (EHR) software?” Some people use the two acronyms interchangeably, but there is a subtle difference. An EMR refers to a system that holds patient records within a practice while EHR refers to a record that can shared with others for better care coordination.
With that cleared up, there are some things you can advise your clients to look for in an EHR and some things to warn them against.
Here are some things to look for:
1. Flexibility in treatment documentation.
One of the main reasons cited for dissatisfaction in an EHR is limited flexibility for documentation. Physicians have a certain way they like to conduct encounters and document them. Asking them to change how they practice medicine is a recipe for disaster. Instead, look for a system that allows each physician the flexibility to set up their documentation preferences in the software.
2. Robust integration.
This is the second main reason given for EHR dissatisfaction. Practices should select an EHR that will work seamlessly with their accounting program, practice management system, and patient portal (if they have one).
3. Cloud-based technology.
For physicians, who are certainly not in the technology business, cloud-based systems are ideal. They eliminate all the hassles of traditional software, including installation, expensive licenses, extensive maintenance needs, and the need for data backup. The application exists “in the cloud,” making it easy to set up, use, and access.
4. Device/browser agnosticism.
Some cloud-based programs are platform independent, meaning they’ll work on any device or browser—but not all. Physicians use a variety of devices and platforms, including laptops, smartphones, iPads and tablets. So they’ll want to choose an EHR that runs on any device and any browser such as Safari, Firefox, IE, or Google Chrome.
5. Data security and availability.
From among the cloud-based offerings, practices should select one that offers robust security and guarantees a high degree of availability. Patient records must be protected to the standards decreed in HIPAA and must be accessible during an encounter.
6. Clear record ownership.
This one is simple. The practice must maintain complete ownership of its patient records so that no matter what happens to the application vendor, the records remain exportable and re-useable by the physician on another system.
There are also a couple of things physicians should try to avoid. First, believing that bigger is better. Many have partnered with large software companies thinking that reputation and brand guarantees a successful EMR implementation and means that future service levels will be high. Unfortunately, this has not always been the case. Several of the largest, most well known companies have sold products to physicians only to then discontinue them, and practices paid a premium for the inconvenience.
Second, avoid vendors that don’t use enterprise-class technology. Choose an application based on reliable, scalable, secure technology that will still be in use years from now.
Finally, physicians and practice managers must remember that it’s not all about the product. The truth is, they can buy the best product on the market, but if their process is faulty, the implementation will fail. The project must have strong stakeholder commitment, followed by sufficient training for the entire staff and a changeover period. During this period, support from the software vendor, the original trainer and the practice’s advanced users will be important.
