Is it time for your practice to go digital?
By Jennie McKee
Michele M. Zembo, MD, MBA, began her discussion about how orthopaedic surgeons can digitize their practices with a quote from Mark Twain: “It’s not the progress I mind, it’s the change I don’t like.”
While she acknowledged that some orthopaedic surgeons may be wary of the potential challenges of transitioning to digital systems such as electronic medical records (EMRs), Dr. Zembo, of the Louisiana State University School of Medicine, explored the benefits of implementing this technology on Tuesday during the Practice Management Symposium for Practicing Orthopaedic Surgeons. Dr. Zembo, along with Glenn Sumner, MBA, and Ira H. Kirschenbaum, MD, presented a session on “Preparing Your Office for the Digital World.”
Dr. Zembo made the case for using EMRs by asserting that it may be difficult for practices for participate in pay-for-performance without the use of information technology (IT). As companies give electronic portable personal health records to employees, she noted, industry observers hypothesize that they may someday discourage their employees from being treated by doctors who don’t use IT.
The benefits of EMRs
EMRs, according to Dr. Zembo, provide an integrated view of patient data, allowing the user to view such critical information as past progress notes, problem lists, past medications, and allergies. They also provide access to resources such as alerts, reminders, knowledge references, and databases for clinical decision support. In addition, EMRs allow for computerized physician order entry.
EMRs benefit patients as well with consumer features such as portals where patients can view test results and schedule visits as well as access educational materials; the EMR system may also generate patient-specific instructions. Other examples of the benefits of EMRs given by Dr. Zembo include potential productivity improvement because of fewer chart pulls, improved billing, improved coding of visits, increased formulary compliance and more accurate prescriptions, leading to fewer pharmacy call backs.
Using EMRs can significantly improve the quality of care provided at a practice because the technology provides such benefits as point-of-care decision support, integration of evidence-based clinical guidelines and easier preventive care, said Dr. Zembo. She also pointed to a potential improvement in job satisfaction for those who use EMRs and increased customer satisfaction among patients who are treated at a practice that uses the technology.
Another reason to use EMRs, says Dr. Zembo, is the potential financial value of the digital system to practices. She noted that EMRs save money by eliminating transcription and reducing dictation while also making it easier for the practice to submit accurate, timely claims. According to Dr. Zembo, the savings achieved in the U.S. health care system from using EMRs could reach $80 billion per year, assuming a 90 percent adoption rate.
It’s okay to start slowly
Possible ways to begin integrating EMRs into a practice gradually can include using “EMR-lite” applications, which give the user the ability to chart electronically but usually have less robust features than a full EMR system. Using an electronic prescribing system or employing hand-held electronic billing are other ways to begin the switch to a digital office.
Physician ownership and buy-in are critical to implementing EMRs successfully, as are identifying a physician champion and practice administrator champion to help the practice make the transition. The selection committee for the EMR system should include different types of practice employees, including nurses, receptionists, and those who are skeptical of making the change to EMRs.
Practices should consider finding out what kind of EMR systems similar practices are using and should obtain crucial information from vendors, such as the kind of maintenance and training support that are provided, before making a decision. The AAOS Practice Management Committee has developed an EMR primer that includes information to help practices make decisions about EMRs. Copies of the primer are available for free at the Resource Center Bookstore, located in the Sails Pavilion of the San Diego Convention Center. After the Annual Meeting, members will be able to access the primer via the AAOS online Practice Management Center.
Following Dr. Zembo’s examination of EMRs, fellow presenter Mr. Sumner discussed digital imaging, which he defined as “the process for acquiring, processing, managing and sorting image data.” According to Mr. Sumner, using digital imaging can be beneficial to orthopaedic surgeons because it “digitizes and more accurately presents critical diagnostic information.” While he noted that digital imaging is expensive to implement, its benefits may be significant, including the potential for images to be moved between hospitals and practices with ease.
Finally, Dr. H. Kirschenbaum discussed how practices can use technology by exploring how orthopaedists can use the Internet to attract new patients.