Bridging the Multi-office Gap With the Ophthalmology EMR EMA™

by Erik Niemi, DO | Dec 17, 2018 | ,

EMA for ophthalmology allows for increased efficiency and reliability for multi-office practices

This appeared as a sponsored post by Modernizing Medicine. Read the original article featured in Ophthalmology Management.

Running any ophthalmology practice in today’s complicated reimbursement and regulatory environment, much less a multi-office practice spread across four sites in two states, poses significant challenges. From losing paper charts and seeing patients in a satellite office with only a few faxed notes to reference, to employing a full-time courier to move charts among offices and dedicating hours to just pull and file charts, it can be frustrating. However, thanks to Modernizing Medicine’s ophthalmology electronic medical record (EMR) system, EMA, those days are long gone.

Advanced Eyecare, PC, is a four-ophthalmologist, two-optometrist practice in Bennington, VT, with satellite offices in Manchester, VT, and North Adams, MA. We also co-own a single specialty ambulatory surgical center (ASC) in Adams, MA. Our surgeons see 30 to 40 patients a day with the help of two techs, while our ODs generally see 20 to 30 patients a day. Our ASC performs between 2,000 and 3,000 cataract surgeries a year.

A 5-Year Journey from Paper Charts to an Ophthalmic EMR

We first began seriously looking at EMRs in 2010, when we were still a paper chart-based practice. The charts we used to rely on were packed with multiple sticky notes containing phone messages and other information. We used to carry portable Dictaphones around with us to dictate letters to referring providers or for outbound referrals.

At the time, we were becoming concerned that the emerging regulatory environment, financial penalties, and incentives associated with Meaningful Use and ICD-10 would force us into an EMR eventually, so we figured, why not start looking now?

We found, however, that most EMR systems were housed on a local server, and we had real concerns about security, server maintenance, and our satellite offices’ ability to reliably connect to a server in our main location. We performed an extensive cost analysis — accounting for ongoing IT support, hardware, and lost productivity — and found that we were actually better off taking the financial penalties than we were implementing an ophthalmic EMR system.

Three years later, however, we reconsidered ophthalmology EMRs. We had a new practice administrator, three of our providers were preparing to retire, and we feared the ancient paper-chart system might hurt our efforts to recruit young surgeons. On top of that, the regulatory issues clearly were not going away, and, since our previous search, some EMRs appeared to have lower implementation costs.

Our lead technician and practice manager came to me with an advertisement for EMA, the ophthalmology EMR from Modernizing Medicine, and I agreed to watch a demo. EMA’s intuitive interface immediately caught my attention, as did its ability to be operated solely from a tablet. I was impressed enough to renew our search, revisiting our top two choices from 2011 — both well-known ophthalmology EMR systems. However, I quickly found that they had not changed much. Despite the popularity of the other systems, I kept coming back to EMA for several reasons.

For one, I found EMA to be far more intuitive, with a clean layout that made information easy to find. The system’s ability to accommodate users with varying levels of comfort with technology was also key — we didn’t want hours of “supplemental” training or complaints about how difficult the system was to use. Indeed, EMA’s ease of use was the most important factor in our decision.

Lower cost was another factor. Providing each doctor and technician with a tablet is far less expensive than buying, installing, and maintaining computers in every lane of our three offices. In addition, EMA’s cloud-based server meant that we no longer needed our own local server. Modernizing Medicine also had far fewer “add-on fees” than other companies. For example, there were no separate charges for connecting every device (DICOM compatible or not).

Specialization was also important. EMA is not just another primary care/internal medicine EMR adapted for ophthalmology — it’s been designed for our specialty from the start. Lastly, the cost-benefit analysis had finally improved in our favor. Even projecting some lost productivity at the beginning of implementation, we were now better off with an ophthalmology EMR system than taking the Medicare penalty.

A Smooth Ophthalmology EMR Transition

Change is never easy — it took us three months to prepare for go-live — but Modernizing Medicine helped make our transition as smooth as possible. One step we took was to visit a site already using EMA. We saw the system in action and picked the brains of people who had already made the switch.

We also designated our practice administrator, our lead technician, and myself to plan and move the transition forward. We met weekly to brainstorm and make lists of potential issues to discuss with Modernizing Medicine’s transition team. Our biggest question: What to do with the paper charts?

We decided to transition gradually, continuing to refer to paper charts at each visit while adding new notes, test results, and other data into the ophthalmic EMR. As we amassed data and our providers got more comfortable, we relied less and less on paper. A related issue was entering each patient’s medical history — conditions, drug allergies, medications, etc. — into the system. For the first year, it was one person’s sole job to enter data into the ophthalmology EMR system, with assistance from our medical records staff. This helped get us back to handling our normal patient load.

The customer service we received during our transition was excellent. Whenever we had problems integrating the ophthalmology EMR system into our current practice management system, Modernizing Medicine’s team was there to quickly answer all of our questions. We also had one contact person throughout the transition, and communication was excellent from start to finish.

It took me only about two weeks after go-live to get back to my normal patient load — about 30 patients a day — and even our slowest staff members got up to speed within six weeks.

Efficiency and Reliability with Our Ophthalmic EMR

Thanks to EMA, our communications and documentation are more efficient than ever. For routine communications (e.g., an annual diabetic eye exam), I can complete and send templated letters to a primary care physician before leaving the exam room. We also have much easier on-call access to patient data—our physicians in any office can read each other’s notes instead of relying on the patient’s explanation.

Questions from a pharmacy or another provider are also easier to answer now that we can pull up the patient record with ease on our tablet. The Intramail in EMA allows us to communicate more efficiently within the office and record calls and/or decisions made for patient care directly into the chart.

EMA is also exceptionally reliable. In the past three years, we have had to resort to paper documentation just twice, and only for part of a day due to Internet connectivity issues. Several of our providers remarked on how inefficient it felt to use paper again, and they were relieved when they could resume documenting with EMA.

Further Efficiency With Our Ophthalmology EMR

We are currently switching from our old practice management system to the ophthalmology practice management system now offered by Modernizing Medicine — and that is a true testament to our experience. We wouldn’t go through another change like that if we weren’t so impressed with EMA and how well we have been taken care of by Modernizing Medicine.

 Interested in seeing how Modernizing Medicine’s ophthalmology EMR can work in your practice?

Erik Niemi, DO

Erik Niemi, DO

Dr. Niemi is an ophthalmologist with Advanced Eyecare, PC, based in Bennington, VT. 

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