One of the key challenges in EHR selection and implementation is accommodating and managing patient service needs. In many cases, practices focus on the charting of patient visits by the doctor, but do not adequately consider the follow-through on patient issues. Such an omission could inhibit your ability to capitalize on your EHR investment.
Patient service issues are not just an EHR issue. Patient service standards and expectations will be evolving as part of the Meaningful Use standards as well as changes in payer focus and patient expectations. For example, some payers are starting programs to incentivize primary care doctors that proactively maintain contact with patients on health maintenance issues. One of the Meaningful Use Menu Measures involves reminding patients about treatment plans. Stage 2 of Meaningful Use includes exchanging messages with patients.
Some patient service issues will directly affect the productivity and efficiency of your physicians. For example, plan items entered by the doctor for a patient can be tracked and managed by the practice staff and cut down disruptions for the physician.
Patient service features and their use cover a range of EHR functionality and use strategies:
Patient Communication – Interacting with patients over the phone and even in the office can be time consuming and confusing for staff and patients. EHR tools allow you to enter, route, and track patient requests and issues. For example, a message entered in an EHR can be sent to a nurse who can review the patient chart online before the message and the paper record can be retrieved in the typical practice. Similarly, a response to a patient question could be sent to the patient through the patient portal rather than playing telephone tag with the patient.
Track Patient Care Recommendations – When a doctor records a treatment plan in an EHR, the entire staff can collaborate on following through on the physician’s instructions instead of waiting for the patient chart to sequentially pass from the doctor to the nurse to the surgery scheduler to the insurance staff, and so on. As important, patient orders can be accessed by appointment and clinical staff to discuss appointments and care issues. For example, a patient who calls for an appointment may need to get a test that was previously recommended by the doctor on a previous visit. With a paper chart, unfilled physician recommendations are difficult to locate and even more difficult to use to determine the status of the recommendation. Note that following through on patient care recommendations will be an evolving patient service standard for physicians as EHHRs are more widely used.
Improve Productivity – EHRs allow physicians to empower their staff to serve patients and address issues. That is not to say that supporting staff is practicing medicine, but that the EHR allows all practice staff to communicate and reinforce the physician’s recommendations to the patient. Similarly, EHRs allow staff to be more helpful and informative. For example, staff can verify that the practice even prescribed a drug before taking the patient’s request for a refill. In the case of surgery scheduling and coordination, more staff could inform or remind the patient about the status of their surgical procedures or the various events leading up to surgery rather than the one person who has the paper chart in most practices.
Triage – EHRs enable a complete reworking of your triage strategy. Since EHRs provide immediate access to the patient record, many practices will be able to answer patient questions when the patient calls rather than take a message. For example, a nurse will be able to immediately access the patient record to review the patient’s situation and inform the patient about the lab results and the doctor’s recommendation. In other situations, the nurse will be able to inform the patient about whether your doctors have prescribed a particular drug when the patient is calling for a refill to the wrong practice. Indeed, practices could centralize their triage calls in a single location and improve response to patients with fewer triage staff. Practices without a triage department will be able to minimize disruptions to doctors and staff serving in-office patients by establishing an economical triage function.
Practice Management – EHRs allow practice managers and doctors to track and manage the flow of patients and events in the practice. With paper charts, practices have little information on evolving problems and issues until a complaint is voiced by patients, doctors, and/or staff. In some EHR products, the practice can monitor a wide range of performance and recordkeeping criteria throughout the day. For example, you can view a list of unsigned notes that are more than 2 days old, or patient messages that have not been answered within 24 hours.
Patient service tools are a critical aspect of an EHR investment. In order to fully benefit from your EHR, you need good charting tools and EHR features that allow you to track, manage and communicate with patients. Relevant EHR features are critical to your patients and offer you the opportunity to provide better patient service on a more timely and responsive basis.
Ron Sterling (800-967-3028, www.sterling-solutions.com) publishes the popular EHR Blog Avoid-EHR-Disasters.blogspot.com, and authored the HIMSS Book of the Year Award winning guide “Keys to EMR/EHR Success.” He is an independent EHR consultant. Hear Ron speak in an archived webinar sponsored by Kareo: What You Need to Know About Selecting the Right EHR. Ron most recently wrote for Getting Paid on Use Results-Oriented EHR Implementation to Avoid EHR Failure.