Just like when you’re preparing to purchase a phone, appliance, car, house, etc., you have questions that you want answered to narrow down your options and find what’s best for your needs and lifestyle. When you start researching a new skin care product, procedure or treatment plan, you have to do your research and have all your questions answered before you move forward with a decision. Just as you go through such a vetting process in your personal and professional life, the same approach should reign true when evaluating technology for your dermatology practice and, in this case, a dermatology EMR system.
You may be wondering, “So what dermatology electronic medical record (EMR) system should I implement in my practice?” We’ve collected some of the top questions along with the answers you should hopefully hear when you’re in the market for a dermatology EMR system and speaking to an EMR vendor.
Although it may seem a bit elementary, let’s start off by defining what an EMR system really is. You’ll often see and hear the terms EMR and electronic health record (EHR) used interchangeably. Both refer to medical records for a patient. Instead of notes being jotted down on paper and stored in filing cabinets, that process is all done digitally and is typically stored on a server (legacy system) or in the cloud (newer software) and data can be captured on a desktop or tablet when in an exam.
As a potential buyer, you need to know what you should be looking for to make sure you select the best dermatology EMR system out there for your practice. So let’s get started with some common questions you should ask when it comes to making a decision on a dermatology EMR system.
1. What is the history and background of your company?
Working with a vendor that has a strong and experienced leadership team and a proven track record of client success can really make an impact on what company you choose. Information like successful attestation rates, top Black Book and KLAS rankings and a strong investment of capital can all play a role when you’re making a decision on an EMR system for your dermatology practice.
Another added perk is working with a company that has practicing specialty physicians on their team, not just as consultants, but rather actually helping to program the software and product. No one knows the way a dermatology practice operates and is more familiar with the office flow than a dermatologist. By having not only a strong development team but also actual physicians involved in the development process, you can help make sure the EMR system can meet your needs as a dermatology practice.
2. Is your dermatology EMR system 2014/2015 certified?
The answer should be a resounding yes. An EMR system that is 2014 or 2015-certified will allow you to meet requirements that are needed to participate in Merit-based Incentive Payment System (MIPS) as well as the Advanced Alternative Payment Models (APM) payment tracks under Medicare reimbursement reform.
What does it mean for an EMR to be 2015 certified? According to HealthIT.gov:
The 2015 Edition Health IT Certification Criteria (2015 Edition) builds on past rulemakings to facilitate greater interoperability for several clinical health information purposes and enables health information exchange through new and enhanced certification criteria, standards, and implementation specifications. Taking into account public comments received on the 2015 Proposed Rule, the final rule continues to focus on the establishment of an interoperable nationwide health information infrastructure.
3. Is your dermatology EMR system easy to use?
The answer should of course be a “yes” and be backed up with the reasons as to why it is user-friendly. There certainly has been negativity in the healthcare industry as a whole when it comes to EMR systems, with people often pointing the finger at EMR technology as the cause of physician burnout. This should not be the case – the right technology, specifically the right EMR system, should really help you practice.
Having an iPad-based EMR system, rather than a desktop system (which many legacy EMR systems use), should allow you to decrease the number of clicks, eliminate typing and allow you to simply tap and swipe your way through documenting a patient encounter. Being able to access a patient record virtually anywhere, at any time is also possible if it is a cloud-based EMR system and not a server-based one, which has been the historic trend with EMR systems.
Often, EMR systems have dermatology templates that can slow you down. Instead, you want to use a template-free EMR system that has dermatology knowledge and workflows built in. Some EMR systems even use an adaptive learning engine to remember your treatment preferences and dynamically mirror your unique style of practice, saving you the time of building templates and freeing you up from being locked into a static template.
Having an EMR system that is specialty-specific, out of the box is critical. When it comes to EMR systems, one size does not fit all. What a family physician or orthopedic surgeon would need varies greatly from your needs as a dermatologist. You should have options, and your EMR system should remember your most frequently ordered tests, what you typically prescribe for certain conditions, etc. And part of this is how the system captures data; you want to ensure what is being captured is structured/actionable data you can use and not just unstructured, narrative data. Overall, your EMR system should simplify your workday, save you time and be intuitive to learn.
Some standout features you should look for in a dermatology EHR system may include:
- An adaptive learning engine that remembers your treatment preferences and unique style of practice and uses a predictive algorithm to anticipate your next move, saving time
- The ability to capture structured data and leverage it to unlock actionable insights
- An iPad-based application to allow you to face and interact with patients rather than turning away to type on a computer
- Anatomical illustrations and drawing tools to help you educate and engage patients while documenting
- An advanced, easy-to-use patient portal that shows patients that you’re on the leading edge of healthcare
- Cloud-based apps for your iPhone and even Apple Watch that let you access patient data from anywhere you have a secure Internet connection
- Integrated photography for documenting exam findings visually or the ability to take before and after photos and associating them directly with a patient’s medical record
- A built-in MIPS solution that lets you document and submit MIPS measures directly from the EMR system and track your MIPS score compared to peers in near real-time
4. Is your EMR system interoperable?
Interoperability is the future of healthcare. Generally speaking, interoperability is the ability of computer systems or software to exchange and make use of information and operate in conjunction with each other. Having an EHR system with built-in clinical interoperability will allow systems to share health data more easily by interfacing with labs, other EHR systems, third-party practice management systems, hospitals, population health registries, health information exchanges and more.
To start with, look for a vendor who is a member of CommonWell Health Alliance. CommonWell is a not-for-profit trade association dedicated to cross-vendor interoperability that helps assure provider access to health data regardless of where care occurs.
Having an interoperable dermatology EMR system can help improve your MIPS performance under the Advancing Care Information (ACI) category as well.
5. What kind of data does your dermatology EMR system collect?
Your EMR system should make it intuitive and efficient to gather and harness the type of information you need when you need it. A lot of this depends on whether your EMR system is capturing structured data. Structured data is the opposite of unstructured or narrative data. This matters because structured data is mineable – it can be uniquely identified and analyzed, even retrospectively, and therefore can deliver actionable insights. It’s a vital piece when it comes to analytics, research and MIPS, which we will touch on more a bit later.
Your dermatology EMR system should capture all the clinical data needed at the point of care. Once that is done, you’ll want to take it a step further so you can really visualize and dig down into what you have collected with an analytics platform – ideally from the same EMR vendor you are already working with. By looking at not just your clinical data but also how that data relates to your financial and operational data, you can improve efficiency, deliver more effective care and increase revenue by answering questions like these:
- Which melanoma or cosmetic patients do I need to follow up with?
- Where am I referring patients for specialty procedures like laser, phototherapy and Mohs? Should I bring those procedures in house?
- What may be causing my surgical infection rate to increase for procedures like biopsies and excisions? What could I do differently to help lower it?
Structured data makes it possible to track these areas in an organized, efficient manner with real-time analytical dashboards, rather than forcing you to try to read through hundreds of individual written records in search of answers. It can also allow you to drill down from a practice level to a provider level and even patient level through applying report filters such as date, facility, ICD-10 code, tax ID and more.
6. How would your EMR system help our dermatology practice automate tedious tasks such as ICD-10 coding and writing notes?
When it comes your EMR system, looking up codes on Google or staying late at the office to type notes should be a thing of the past. Based on the data you captured during the visit, your EMR system should automatically generate ICD-10, CPT and modifier codes, as well as prescriptions, lab requests, written notes, completed encounter forms and patient education handouts – all in just seconds. With an integrated, single-vendor solution, your EHR and PM systems may even be able to work together to auto-generate thorough bills with procedures, diagnoses, services, fees and more.
This saves valuable time and eliminates the need for typing, so you can finish documenting before the patient even leaves the room. Advanced coding automation at the point of care can also help you improve billing accuracy, justify higher coding levels and reduce claim denials, which helps increase your income. Structured data makes all these automated features possible.
7. What other products and services does your company provide in addition to an EMR solution?
Consolidation is key. The fewer vendors you have to use, the better. Using an all-in-one solution that can fit the needs of your dermatology practice while eliminating the expense and IT headaches of system bridges is ideal. When you can work with one company who can provide a complete solution including:
It will make day-to-day workflow much more manageable and effective for you and your staff. You’ll be able to work closely with one vendor on a complete solution for your dermatology practice, rather than trying to fit multiple vendors together like a messy jigsaw puzzle.
8. How can you help our practice succeed under value–based care, specifically the Merit–based Incentive Payment System (MIPS)?
Centers for Medicare and Medicaid Services (CMS) is paying providers on a curve under MIPS, so you can earn a bonus for scoring above average or a penalty for failing to report. You want your EMR system to capture your MIPS data within the flow of the exam, with built-in technology that can calculate your MIPS score in near real time, both for each individual category and for your overall composite score. The data collected should allow you to benchmark your performance against your peers in near real time as well as against historical CMS data. This helps you track your performance as you go, so you can make adjustments now, instead of finding out you’ll be penalized when it’s already too late.
A robust structured-data EHR system can go beyond just streamlining data collection and performance tracking and even automate the actual reporting and submission process. For instance, specialized registries integrated with the EHR system can let you submit patient diagnoses, demographics, treatment methods, and treatment effectiveness data automatically. This helps you advance population health while effortlessly earning MIPS bonus points in the Advancing Care Information (ACI) category. And when the MIPS reporting period arrives, a built-in EHR MIPS solution can submit your data directly to CMS, so you don’t need to enter it again on a separate site. Not to mention, you’ll earn bonus points for reporting through your EHR (6 in ACI if you select an Improvement Activity that is done within the EHR system). All this will save time and resources on MIPS management and reporting.
Additionally, having access to a team of expert advisors to guide you along the journey of value-based care will help you achieve MIPS success and help put you ahead of the curve.
9. I know how important patient engagement is, especially under value–based care. How will your EMR system help me engage my patients more?
Having access to a telemedicine application through your EMR vendor, as well as tools such as a patient kiosk and patient portal, can be effective ways to increase buy-in from your patients and engage them in their own healthcare. This, in turn, helps improve patient outcomes. Ask your vendor about what options are currently available, what’s planned for the future and which features are included with the EMR system versus add-ons.
An interactive patient education tools like body illustrations, drawing functionality and patient outcome timelines is an added bonus. This fosters more meaningful interactions in the exam room to get your patients more engaged from the start, which, in turn, makes them more likely to leverage tools like a patient portal later on.
10. What training and support options do you provide?
Both before and after you are up and running with your new EMR system, you want a company with a strong implementation, training and support teams. You should have options to select the training plan that works for you and customize it for your individual office needs. Just like a one-size fits all approach doesn’t work for EMR systems, neither does the training. Flexible, individualized trainings allow you to receive knowledgeable assistance from a team that has a medical background in dermatology and give you the ability for your practice to stay open while you train and go live with the system, rather than having to close.
Ask about what the training options entail. Some questions you may want to ask could include:
- Can the trainings be done on-site at your practice?
- Can training be done remotely?
- Could we come to the company’s headquarters?
- Is there an annual users conference?
In addition to the personalized training, there should be other resources and a knowledge base available where you can research how-to videos, tips and tricks and even compare notes with other clients. Training and support should be ongoing and extend beyond simply the on-boarding process. Educated, responsive support is key at all stages of your EMR system use.
11. Can you share with us some of your references and clients you work with?
Just as you read reviews before you dine at a new restaurant or purchase a car, one of the best ways to really learn about both a company and their products is speaking with current users. You should connect with physicians and staff who currently use the dermatology EMR system. You can ask for things such as:
- Case studies
- Video testimonials
- A phone conversation with a current user
- An on-site visit at a practice
- And availability to speak with current users at upcoming dermatology conferences
At the end of the day, you have to select the best dermatology EMR system for your practice’s unique needs. The vendor you choose should be able to answer all these questions and more and really understand what’s important to you. Only then can they provide the best solution to help you and your dermatology practice achieve clinical, financial and operational success.
The AuthorJordan Miller, MD
Senior Medical Director of Dermatology
Dr. Jordan Miller is the Senior Medical Director of Dermatology. As one of Modernizing Medicine’s first clients, he quickly became a “super-user.” Today as a practicing dermatologist Dr. Miller leads development of the dermatology-specific electronic health record system and works with clients to the create specialty-specific software.