Moving to electronic medical records will improve
patient flow,
allowing for increased physician-patient contact
An old axiom reminds us that “time is
money.” In today’s environment of private practice, these words
are especially true. Facing the challenges of constantly increasing costs
of doing business such as rent, salaries, and utilities, coupled with
decreasing reimbursements for care, many health care practitioners are
looking for time-saving methods of practice that are cost-effective and
offer patients quality care at the same time.
One method of attaining this outcome is to move toward
implementing increased technological changes in the office. Over the past
several years, information technology has affected practically every aspect
of our lives, both personal and professional. When appropriately used,
technology could effectively replace old practice challenges and
frustrations with new possibilities and solutions. Interestingly, it
seems one area that is slowly embracing this technological evolution is our
health care system.1 The conclusion of a study investigating
physicians’ experiences with computers in a clinical environment
concluded that individuals with greater computer experience tended to
accept the use of electronic medical records (EMRs) and tended to be
younger.2 As of 2006, adoption of EMRs and other health-information
technology has been minimal. It is estimated that less than 10% of American
hospitals have implemented health-information technology, while a mere 16%
of primary care physicians use EMRs. The majority of health care
transactions in the United States continues to be through a paper-based
system that has virtually remained unchanged since the 1950s.3
An array of legal, ethical, and clinical issues
require consideration in deciding the best approach to record keeping.
Physicians are required by law to ensure that patient information is
secure. Physicians must be alert to breaches of privacy from hackers,
viruses, and accidental leaks. Some steps physicians can take to protect
patient information is to back up information frequently and place those
backups in a separate location under lock and key in a moisture and
fire-proof location. Keep antivirus software in place and up to date. Make
computer-security procedures standard office policy, and place those
policies into the office manual. Assign user names to staff and place
layers of access, which will only allow employees to enter certain areas.
A major concern of physicians is the adequate privacy
protection of the individuals whose records are being managed
electronically. This class of information is referred to as Personal
Healthcare Information, and its management is addressed under the
Healthcare Insurance Portability and Accountability Act (HIPAA), as well as
many state-specific privacy laws. The authorized individuals responsible
for managing this information are required to ensure that adequate and
appropriate protection is provided and that access to the information is
only by authorized parties. If properly protected, EMRs will be as secure
as banking records.
Paper-based record-keeping systems need to be updated.
Paper-based records are adding expense to the bottom line and are
time-consuming, keeping physicians and staff away from patients who are
attending to the volumes of paperwork necessary to efficiently and legally
maintain the standard of care. Paper-based offices spend financial
resources on record storage. Support staff, transcription, and delayed or
missing paperwork can lead to duplicate clinical procedures.
No matter what size of health care facility you are
running—whether it is a single-physician, privately owned and
operated office or a multidisciplinary practice with several attending
clinicians—similar challenges and demands exist while making the
transition to electronic health records. These changes will ultimately
improve patient flow by streamlining procedures and expanding networked
access, allowing for increased physician-patient contact.
EMRs are computer-based patient medical records and
facilitate access of patient data and accurate and complete claims
processing by insurance companies. There are automated checks for drug,
nutrient, and allergy interactions; clinical notes scheduling; sending and
viewing x-rays; magnetic resonance imaging; computerized tomography; and
other imaging and laboratory reports.
Streamlining Your Practice
One procedure that physicians are using to shorten the
time new patients need to complete the increased volume of required forms
is to let patients download the necessary new-patient questionnaires,
complete them in the comfort of their homes, and bring the forms with them
on their first office visit.
One way to streamline clinical practices is to use a
digital scanner, an instrument used to create and order orthotics.
Previously, physicians had to cast patients by having them stand in a foam
box to make an impression. The patient would take this impression to the
post office, pay for shipping charges, and wait for it to be mailed,
delivered, and returned to the physician’s office. This delay in time
can prolong necessary treatment to the patient and possibly lengthen
treatment by delaying healing time.
Scanning patients can be efficiently done as a
standard part of every new-patient examination. This procedure gives the
doctor potentially valuable clinical information regarding the
patients’ lower-extremity and kinetic chain, which can influence the
entire musculoskeletal system. The digital scanner is one of the few ways
to evaluate all arches of the feet from a unique perspective—from
underneath. This is the only perspective from which the patient can also
view all three arches of the foot. The scanner produces a customized report
appropriate for patient education.
One of the many challenges facing health care
professionals today is improving the quality of patient care by decreasing
dependence on hand-written notes. Electronic health records can improve
patient care by allowing greater access to information, curtailing medical
errors, and reducing test wait times with faster, easier workflow.
The patient file is an important legal document in
third-party relationships. Poor or inadequate documentation of patient care
is a major contributing factor in unfavorable legal judgments against
physicians.1
A successful practice depends on the productivity of
caregivers and the efficiency of staff. Physicians frequently lament
spending most of their time completing paperwork instead of treating
patients. Too often, staff members are wasting time looking for lost
records, duplicating files or parts of files, and waiting for records that
must be inaccessible during transcriptions. Electronic records can decrease
paperwork for physicians; reduce paperwork time and improve productivity;
and maximize workflow efficiently.
Occasionally, patient records, test results, and other
critical information are not available when needed, being misplaced or
sometimes completely lost. Electronic health records reduce the possibility
of misplaced or lost files. Physicians can obtain better information at the
point of care, and critical data will be available when necessary.
Inefficient procedures raise the cost of health care;
paying staff for pulling, filing, and maintaining charts is not
cost-effective. Conversion to an electronic system greatly reduces
paperwork and record filing and retrieval. Physicians can recover lost
physical space used for record storage. An electronic system reduces costs
of paper, printer ink cartridges, and other office supplies. It reduces
chart-management and transcription costs.
The requirement to protect patient confidentiality is
critical. Implementing electronic records provides resilient security to
patient information and makes compliance with privacy regulations easier to
implement.
Manuel A. Duarte, DC, MS, DACBSP, DABCO, CSCS, is a graduate of National College of Chiropractic. He has
extensive teaching experience and lectures on a variety of topics,
including manual treatment procedures, rehabilitation, orthopedics, and
sports medicine. Contact him at CPEditor@ascendmedia.com
2. DD Cooke, Attitudes About Electronic Medical Record
Keeping. Paper presented at: Southeastern Medical Informatics Conference;
June 12, 1995; Gainesville, Fla.
Moving to electronic medical records will improve
patient flow,
allowing for increased physician-patient contact
A major concern of physicians is the adequate privacy
protection of the individuals whose records are being managed
electronically. This class of information is referred to as Personal
Healthcare Information, and its management is addressed under the
Healthcare Insurance Portability and Accountability Act (HIPAA), as well as
many state-specific privacy laws. The authorized individuals responsible
for managing this information are required to ensure that adequate and
appropriate protection is provided and that access to the information is
only by authorized parties. If properly protected, EMRs will be as secure
as banking records.
A successful practice depends on the productivity of
caregivers and the efficiency of staff. Physicians frequently lament
spending most of their time completing paperwork instead of treating
patients. Too often, staff members are wasting time looking for lost
records, duplicating files or parts of files, and waiting for records that
must be inaccessible during transcriptions. Electronic records can decrease
paperwork for physicians; reduce paperwork time and improve productivity;
and maximize workflow efficiently.
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