Case Study

Krieger Eye Institute Increases Productivity With Help From the iPad EMR System, EMA™

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The Goals

  • Increase productivity
  • Utilize an EMR that provides portability and mobility
  • Increase face-to-face patient interaction
  • Improve prescription writing process

Key Benefits Experienced

  • Ophthalmology electronic medical records (EMR) system
  • Enhanced patient interaction through use of iPad EMR for documenting
  • Automatic suggested ophthalmology coding
  • Ease of use helps increase productivity

Dr. Abrams shares his ophthalmology EMR success.

“After a short six weeks of using our previous EMR system, our productivity had plummeted so significantly that we couldn’t afford to continue using it. Within one month of using EMA, we were at 108 percent of productivity, which warranted that we had made the right decision.”


This post was originally published in April of 2015 and updated on January 7, 2019. 


When Dr. Don Abrams became the chairman of ophthalmology at the LifeBridge Health Krieger Eye Institute at Sinai Hospital in Baltimore, Md., he knew he wanted to implement an ophthalmic EMR system. He began looking at numerous systems that would support their various clinic locations, residency and fellowship programs and their multiple specialties only to be left with a disappointing solution.

Dr. Abrams explains, “We started using an EMR system in 2008 that we quickly found to be very cumbersome and outdated. The input of data was time consuming and the output was indecipherable. After a short six weeks of using the system, our productivity had plummeted so significantly that we couldn’t afford to continue using it. At that point we transitioned back to paper and I continued my search for the right ophthalmology EMR system.”

“In early 2014 it became clear for Meaningful Use attestation and the upcoming ICD-10 requirements that we needed to implement something quickly. Choosing an ophthalmology EMR system is a daunting task, especially if you are a large institution like we are and have multiple requirements,” he said. “One of my colleagues recommended Modernizing Medicine’s ophthalmic EMR system, EMA. I wanted a system we could use seamlessly that did not require us to sign in and out every time we walked into an exam room, and EMA fit the bill. It also runs on a native iPad application, which allows me the portability and ease of use that I was searching for.”

“We signed up with EMA in March and were live in June. It was an ambitious implementation schedule but it went very smoothly and successfully. One of the main problems that we were worried about was productivity given our previous experience. Within one month of using EMA, we were at 108 percent of productivity, which warranted that we had made the right decision.”

An Ophthalmology EMR

“EMA has the benefit that it was designed and coded by ophthalmologists and it shows in the quality of data that is in the system. Particularly the pretesting areas where we document interactive pressures, revisions and refractions are really well done. EMA also works very well for my anterior segment sub-specialties of glaucoma and cataract. It will actually prompt me to remember a condition that a patient has and also trigger my memory by showing past diagnoses,” said Dr. Abrams.

“Because ophthalmology is so data specific and there are so many data points to document during an exam, it can become cumbersome using a system that has multiple screens and spreadsheets. With EMA, the structured data is gathered in such a simple and comprehensive way. The screens change immediately and it’s as convenient as a quick tap to navigate through the data. When a patient is already in EMA, you can select which pieces of the impression and plan you want to bring forward and it takes virtually seconds to do that. I have never seen another program that was this easy to use.”

iPad EMR System Enhances Patient Interaction

EMA is iPad-based allowing Dr. Abrams to focus on his patients and not his EMR system. The iPad provides him with the portability he was looking for along with the speed to expedite his exams.

“Other EMR systems I had researched were based on laptops or wall-mounted computers. Every time you turn to one of those machines you are turning your back to the patient,” Dr. Abrams explained. “One of my requirements was to have a system that we could actually use while still looking at the patient, so that meant something portable. I wanted our ophthalmology EMR system to enhance the patient experience and not take away from it. Since the easiest device to use is an iPad and EMA works so well as a native iPad application, it was the best alternative out there. I can pull up the patient’s eye log and show them their pressures over time and walk them through the plan as I’m documenting.”

“Prescription writing through EMA is absolutely unbelievable. I used to think the most efficient way to write a prescription was on paper. It is faster to write a prescription through EMA than it is on paper. You have better control over the aspects of the prescription, you can sit in front of the patient and reassure yourself that you are sending it to the correct pharmacy all while you’re interacting with them.”

An Ophthalmology EMR in the Palm of Your Hand

Dr. Abrams and his team also use PocketEMA™, the smartphone version of EMA that is available on iOS and Android phones. “A lot of our physicians who are on call use PocketEMA, and I hear comments everyday about how easy it is to pull up patient information in the middle of the night. In years past, they never had the ability to do that as they either couldn’t find the chart or wouldn’t even know where to begin to look,” Dr. Abrams said. “Also, if technicians are writing refills that I need to sign, they can text me and I can sign which takes seconds from my iPhone.”

Automatic Suggested Ophthalmology Coding

EMA has intelligent suggested coding built into the system that helps Dr. Abrams to code with confidence. “The attention to detail as far as coding is beyond anything I have ever seen. EMA really tracks what you are doing. I had been under coding for years on paper for fear of not having documentation to justify higher coding. With EMA, it’s amazing how it reviews the documentation in the record, and then suggests codes automatically based upon it.  And all of the data points are positioned with the appropriate number of diagnoses. I’m glad I had EMA for ICD-10, which was an effortless transition.”

The Future With Our Ophthalmology EMR, EMA

“I am really looking forward to the future with EMA. The ongoing support and the expertise that are behind the scenes at Modernizing Medicine proves that EMA is only going to continue to evolve and stay an amazing product.”

Want to learn more about the ophthalmology software Dr. Abrams discussed?


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