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EHR System Review: How I’m Winning the Race Against MIPS and Physician Burnout


The Merit-Based Incentive Program (MIPS) is a subset of the Medicare Access & CHIP Reauthorization Act (MACRA), and has been top of mind for many ophthalmologists and other physicians since its announcement in 2015.

MIPS ultimately changes how Medicare pays entities who give care to its beneficiaries. It’s based on the idea that if you demonstrate higher quality and/or lower costs than your peers, you have the chance to increase revenue overall. On the contrary, if you perform lower than fellow physicians, you’ll wind up losing money.

The multiple stressors associated with policy changes and quality measurements have led to extreme exhaustion among physicians. Quite frankly, it doesn’t surprise me that physician burnout has become such a hefty phenomenon, with 50 percent of physicians’ administrative work being completed during a patient visit, and 50 percent afterward — technically gratis.

I too once fell victim to the time suck of administrative tasks, which unfortunately cut into time otherwise spent with my family and hobbies outside of the office. There’s no question: the reporting delay associated with paperwork also poses a greater chance that an ophthalmologist could make a major error and, as a result, won’t be reimbursed for their hard work.

So what does an ophthalmologist do to adhere to the legislation trickling in (ever so quickly), striving to perform to the best of their ability, all while properly documenting every single quality measure and clerical task to keep up with constantly shifting compliance mandates, i.e. HIPAA, Meaningful Use, PQRS and soon to be MIPS? Queue healthcare IT, specifically an electronic health record (EHR) system, to help fix this unhappiness plaguing our industry. It’s imperative to employ the right EHR system, one tailored to your ophthalmic needs, which can automate key administrative tasks, ensuring you, your practice and your patients will succeed.

By implementing the right technology and ultimately increasing efficiencies overall, you’re bound to stay ahead. In my opinion, the right EHR system should include:

  1. Structured Data: Enables me to document and track my patients’ progress during the appointment — not after. A good EHR system should be able to auto generate reports for quality measures such as PQRS and Meaningful Use, which ultimately saves me time and helps ensure reimbursement is tied to outcomes.
  2. Adaptive Learning: An EHR system should remember my most commonly executed tasks and preferences, thanks to predictive algorithms. For example, with my current EHR system, most common ophthalmic conditions that I see are at the top of my list, as well as my treatment preferences.
  3. Protocols: I should be able to create master visits for frequently encountered conditions. These user-designed protocols can then be applied to exams like routine visits, new patient exams and pre- and post-procedural instruction. It is also helpful if the EHR system is cloud-based, so all physicians in the practice can access them in multiple office locations, which saves tons of time.
  4. MACRA and MIPS Made Easy: MACRA and MIPS will have far-reaching implications for our practices, and the time is now to prepare. As trite as it sounds, some of today’s EHR systems are taking addressing MIPS and MACRA to the next level.  Today, many outcome measurements — including advanced cataract and retinal detachment — are automatically recorded, filtered, analyzed and are prepared for submission without any additional work from the provider.

My go-to EHR platform, which meets all the four key functions listed above, was actually coded for ophthalmologists by ophthalmologists — EMA™, the EHR system in Modernizing Medicine’s cloud-based suite, modmed Ophthalmology. It’s putting me ahead of the race when it comes to adapting to the increasingly dynamic healthcare environment. With the impending legislation, it’s more important than ever to find an EHR system that can not only reduce the administrative burden, but also improve physician satisfaction.

Even with all of the complicating factors on the horizon, and a growing task list for physicians associated with quality reporting and compliance, the future for ophthalmologists shines bright. With the right EHR system, we can overcome physician burnout thanks to technological advances in our industry, which easily help us to stay ahead of the pack. I’m excited to walk into work each day, knowing I’m able to bypass strenuous after-hour paperwork and focus on what I love most: helping my patients.

By: David A. Goldman, MD on in News