Our EHR Journey: Where We Are Now

Our EHR Journey: Where We Are Now

Karen Perry, OD, FAAO

What the practice has lost in paper, it has gained in efficiency and patient satisfaction.

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Almost 2 years into our conversion to electronic health records (EHRs), our practice functions much differently than it did when we began this process. Our office is almost entirely paperless—a big accomplishment—but not handling paper charts is not the biggest difference in our day-to-day practice experience. More reliable and accessible information and enhanced clinical efficiency have been our biggest EHR-driven gains thus far. In fact, our EHR system has enabled us to change our practice workflow dramatically.

Web-based Intake

The examination now starts well before the patient enters our office. We ask all patients to complete the intake forms—available on our Web-site—prior to their appointments. The use of a telephone interview and Web-based forms allows us to capture information in advance. When patients complete the forms on our Web site, a simple click will submit the data automatically to our office, where we are able to download the information and transfer it to the patient’s EHR—all long before the patient arrives at the office.

In the office, laminated forms are used to capture all required signatures (eg, HIPAA forms). Signed forms are scanned as a PDF file and saved to the patient’s EHR. The laminated form is erasable and can be recycled by wiping it clean for the next patient. We look forward to direct digital signature capture, as this will eliminate the scanning step.

Upon arrival at the practice, patients who have submitted intake forms online are quickly escorted directly to the pretesting area. This reduces patient waiting time and eliminates delays in the doctor’s schedule. Patients truly appreciate reduced waiting time; it signals that we value both their time and their business.

Easy Notation

During the clinical exam, results can be recorded quickly using the drop-down menus on our Compulink EHR System. The choices in these menus are highly customizable (even on the fly). When appropriate, one click of a button can populate all fields with a default “normal” value (especially time saving with young, healthy patients). The drop-down menus can be reserved for abnormal findings. As a result, less time is spent documenting basic information and there is more time to consult with patients.

The logical flow and legibility of exam documentation in the EHR provides ease of continued care and patient referral. Additionally, all specialty testing (eg, VF, OCT) or photo-documentation can be captured and saved to the patient’s EHR record. The photos and reports can be easily exported for e-mail to the patient or a specialist.

At the end of the exam, prescriptions are finalized with a click of a button, and the documents are printed and waiting at the front desk for the patient to check out. I simply explain to the patient, “You’ll receive contact lens instructions, your contact lens prescription, and a copy of your eyeglass prescription at the front desk.” I no longer have to write prescriptions and locate information while the patient is in the chair. This creates a more professional environment and seamless experience for the patient.

The EHR system also features electronic prescribing (or e-prescribing) capabilities, so prescriptions can be submitted directly to the patient’s pharmacy. Patients appreciate this because the prescription is waiting at the pharmacy when they arrive.

The Bottom Line

The evolution of our EHR system is far from over; however, after almost 2 years, we have made significant progress. Our practice is now almost entirely paperless, thanks to Web-based intake forms, electronic records, and digital communication. Because of documentation that is more proficient, with drop-down menus and auto-coding functions, we are able to dedicate more time to patient communication and practice development. As a result, our practice is more efficient and patients are impressed with the seamless nature of our care.

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Karen Perry, OD, practices with her husband Mark Perry, OD, at Perry Eye Care Associates in Orlando, FL. Assistance in the preparation of this manuscript was provided by medical writer Diana Friedman.