EMR BIG BOX DISSATISFACTION - nextech.com · in an EMR vendor is an integrated software solution...
Transcript of EMR BIG BOX DISSATISFACTION - nextech.com · in an EMR vendor is an integrated software solution...
EMRBIG BOX DISSATISFACTION
Pushes Demand for Specialty Specifi c Systems
ONE SIZE DOES NOT FIT ALL
WHITE PAPER
ONE SIZE DOES NOT FIT ALL
Due to the unique needs of specialty practices, the
majority of these providers are dissatisfied with their
general practice electronic medical record (EMR)
software. In fact, according to a recent IDC Health Insights
report, 58 percent of providers are disappointed with their
system’s usability, and 66 percent stated that because of
increased documentation and lost productivity, they are
seeing fewer patients. Because of this discontent, specialty
providers are seeking out customizable, specialty-specific
EMR solutions that meet the unique workflow needs of
their practice and of each individual within the practice.
Similar sentiments were expressed in a 2013 Black Book
survey, where managing partner Doug Brown is quoted as
saying, “Some popular one-size-fits-all EMR products
have not met the needs of several specialists and
cannot continue to satisfy their client base with a lack
of customizable or bespoke tools.” This Black Book survey
asked the question, “Are you seeking a vendor who has
demonstrated capabilities and success with practices in
your specialty as a replacement EMR?” The response to the
question was staggering—92 percent answered yes, one
percent said no and seven percent were unsure. The results
of this survey clearly show the demand for customizable,
practice-specific solutions.
General Practice EMR Dissatisfaction Pushes
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TARGETED FEATURES FOR UNIQUE
SPECIALTY PROVIDER NEEDS
The reasons for dissatisfaction are as diverse as the users’
expectations. Depending on the specialty, size of the
practice, organizational structure, business processes and
the technological knowledge of the staff, each provider
expects different functionalities. However, with many
general practice EMRs, providers are forced to adapt to
the systems’ predesigned structures, rather than have the
solution meet their unique workflow.
While this varies by practice, there is a range of features and
capabilities that specialty providers find extremely valuable.
In the aforementioned IDC Health Insight report, the top
reasons for implementing an EMR were:
• 82%: to achieve a reduction in the number of lost or missing charts.
• 75%: the ability to access medical records remotely.
• 56%: to earn incentive payments.
However, after implementing general practice EMRs, many
practices’ needs are not met, and as a result, providers tend
to abandon their systems.
TARGETED FEATURES FOR
Demand for Specialty Specific Systems
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85%Spending more time
on documentation2
66%Seeing fewer patients3
58%Specialty physicians said they
were dissatisfied with their
system’s usability
SPEED of Documentation
and PATIENT VOLUME
TOP REASONS SPECIALTY PHYSICIANS
WERE DISSATISFIED WITH THEIR EHR:
34%were very dissatisfied
with the ability of their
EHR to decrease workload
32%of respondents had not
“returned to normal
productivity” compared
to 20% in 2010
37% in 2012 were dissatisfied
with the EHR’s ease of use
OTHER RESULTS
FROM THE SURVEY INCLUDE:
82%Reduction in the number
of lost or missing charts
75%The ability to access medical
records and work remotely
56%Incentive payments
TOP REASONS SPECIALTY PHYSICIANS
WERE SATISFIED WITH THEIR EHR:
Accessing Patient
Information
Documenting Care
ePrescribing
Viewing Labs and
Diagnostic Tests Results
Entering Orders
1
2
3
4
5
DOES YOUR SYSTEM WORK
WITHIN YOUR WORKFLOW?
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CUSTOMER RELATIONSHIP MANAGEMENT
One key feature that many specialty practices look for
in an EMR vendor is an integrated software solution for
marketing that allows the practice to utilize its EMR as a
customer relationship management (CRM) system. This
is especially important to specialists that deliver elective
procedures, so that they can reach out to their customers
and market their practice. This type of software module
provides the ability to evaluate business development
activities, such as calculating the return on investment
(ROI) from marketing efforts and tracking patient referrals.
This system also includes tools to calculate business ratios
that help practices make decisions on advertising budgets
based on consult-to-patient conversion rates and revenue-
to-expense graphs for different referral sources, which can
become a significant revenue driver.
MOBILITY
Furthermore, as stated in a recent article by Medical
Practice Insider, specialty practices, especially surgeons,
also have much higher patient volumes compared to their
generalist counterparts, which makes it even more crucial
that they are able to improve efficiency. Because of this,
many specialty practices require an EMR system that allows
them to chart and document anywhere and in real time,
using mobile devices like an iPad. In addition to being able
to walk from room to room without having to log in to a PC,
the iPad camera allows specialists, such as dermatologists
and ophthalmologists, to capture, store and retrieve images
for clinical documentation. This mobile capability based on
tablet technology allows physicians to chart almost as if
they were using paper, which is an important feature for
some specialty providers. The wireless connectivity of a
tablet also gives physicians anywhere, anytime access to
patient data and scheduling information.
INVENTORY
Ophthalmologists, plastic surgeons, dermatologists and
several other specialty practices also have a critical need
for an inventory management solution. For example,
ophthalmologists need to send and order directly from
their EMR to their optical shop software. With this capability,
when a patient walks into the optical shop to pick up their
prescription, the order has already been placed and the
practice has essentially “captured” that person in their own
optical store. This is a huge convenience for patients and
a major source of revenue for the provider; in fact, optical
dispensaries account for about 45 percent of the total
revenue in a dispensing ophthalmology practice, according
to a recent Review of Optometric Business report. Without
this integrated capability, ophthalmologists can lose a
significant portion of their optical shop revenue to discount
chains or stores.
Because of these unique needs, having an EMR and practice
management system that is optimized to each specialty’s
workflow, meets their unique practice requirements, and
allows them more time to see patients is highly desirable.
Integrated Software Solution
An EMR and practice
management system
that is optimized
to each specialty’s
workflow, meets
their unique practice
requirements, and
allows them more
time to see patients
is highly desirable.
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Anytime, Anywhere Access
CUSTOMERRELATIONSHIPMANAGMENT
patient engagement
practicemanagement
emr
inventory
revenuecycle
managementanalytics
marketing
In addition to improving workflows and efficiency,
increasing coding requirements and additional
practice management needs have added an extra layer
of responsibility to providers’ job functions. Indeed,
it represents their chief complaint with regard to general
practice EMRs or hospital EMR solutions, which were never
designed for specialty providers and were made to be all
encompassing, rather than customizable. These general
practice EMRs, commonly referred to as “big box” EMRs,
were designed to meet the lowest common denominator
and work for everyone, but in reality, these EMRS cannot be
all things to all people.
With general practice EMRs, providers have to develop
“workarounds,” which typically involve a great deal of typing,
dictation or even transcription of charting information and
data. With practice-specific solutions, time-consuming
workarounds are unnecessary, and providers can finish
their charts as they complete their patient encounters, sign
off and create a bill or order simultaneously.
Another issue for specialty providers is that there are
uncertainties around how to improve patient care in their
particular setting if they don’t have an EMR solution that
is customized to their practice. From their perspective,
many of the big box solutions they struggle with often
generate a disjointed patient record. One of the key
drivers in improving patient care for a specialist is having a
practice-specific solution that can store, track and manage
a complete record of their patient’s medical history. With
the growth of specialty practice solutions, finding the right
EMR and practice management system is becoming an
ever more critical business decision.
Every Minute Counts: Solutions Made
For most specialty
practices, every
minute spent on
documentation,
placing orders,
billing and other
tasks means less
time with patients,
so speed and ease
of use are crucial.
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When selecting an EMR, providers should carefully
consider the following questions and issues, such as:
• How will the software help the practice run more efficiently?
• Is the EMR fully integrated with the practice management system and additional modules, or is it composed of multiple systems?
From a technology perspective, “fully integrated” means
that the entire system is running on a single database.
Solutions that are not single-source may have much of
the specialized functionality that might be required for the
practice, but it won’t be particularly helpful if physicians
and staff have to log out of one module in order to log in
to and access another. For most specialty practices, every
minute spent on documentation, placing orders, billing
and other tasks means less time with patients, so speed and
ease of use are crucial.
The software modules such as inventory control,
marketing, mobility and imaging should all work
together seamlessly with the practice management
component. During a demo of the software, the solution
provider should be able to clearly show how this works.
Another very critical issue to inquire about is how much
specialty-specific content the software company is able to
provide with their solution.
AN INFORMED INVESTMENT: Ask the right
questions to select the best solution for your practice.
In a 2013 Black Book report, providers overwhelmingly
noted that their current EMR did not meet their needs and
79 percent of respondents attributed this discontent to the
fact that they did not adequately assess their own needs
before choosing a vendor. In this same report, 92 percent
of specialists now say that they want clear proof of success
before signing a new contract.
As such, it is important that physicians are fully prepared
to ask the right questions during a vendor demonstration.
For example, physicians should provide their own clinical
case studies and ask to see them incorporated into the
software demo. Another aspect of preparing for a software
demonstration is to ask a software vendor to show how
they can create a template for the most frequently used
CPT codes used by a practice. Many specialty practices
use a relatively small number of codes in the course of an
average day. In addition, providers should ensure that the
EMR is able to customize various templates to meet their
workflow and that the staff can be trained to quickly and
easily create their own templates.
with Specialists’ Time in Mind
Big Box v. Practice-Specific THE BIG PICTURE
SPECIALTY SPECIFIC
Customizable to the practice and providers needs.
With practice-specific solutions, time-consuming
workarounds are unnecessary, and providers can finish
their charts as they complete their patient encounters,
sign off and create a bill or order simultaneously.
Practice-specific solutions can store, track and manage a
complete record of their patient’s medical history
BIG BOX
Designed to meet the lowest common denominator
and work for everyone.
Providers have to develop “workarounds,” which
typically involve a great deal of typing, dictation or even
transcription of charting information and data.
Generates a disjointed patient record.
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NO TWO PHYSICIANS
CHART THE SAME WAY
Every provider has slightly different documentation
and charting methods, and the ability of the software to
map to their personal preferences greatly enhances their
satisfaction with the solution. As mentioned in a Health
Affairs article, for example, most clinicians need to chart
the same information within a practice, but physicians
vary greatly in how they document progress notes. Some
doctors prefer to dictate their notes directly into the EMR,
while other users prefer to type data to templates and
electronic forms.
A truly customizable solution should utilize flexible
templates to customize charting and workflow to meet the
needs of every user within a specialty practice. A system
that is not properly customized could lead to fatigue and
can cause physicians to use the system improperly, in turn,
making it difficult to qualify for meaningful use incentives.
THE IMPORTANCE OF PERSONAL,
INTERACTIVE TRAINING
As cited in a 2013 report published in HealthLeaders, EMR
implementation alone was not enough to improve patient
care. Researchers reported that it took physician practices,
a minimum of nine months of EMR exposure, combined
with eight or more site visits to demonstrate any significant
statistical improvements in key quality measures.
This highlights the need for personalized, interactive
training that allows staff to learn how to customize a
template so that it precisely meets their charting needs
and workflow preferences. This training methodology not
only creates the templates that each person needs, but it
teaches them to quickly and easily customize or modify a
template that they might want in the future.
The ability of the
software to map to
physician’s personal
preferences greatly
enhances their
satisfaction of
the solution.
Preparing for Success with Customized
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As a part of this training, EMR specialists should work with
all of the staff members to implement the workflows that
each person in the practice wants. This allows each user
to see and learn exactly how each template is modified
according to what they have requested.
SUPPORTING EMR GO-LIVE
WITH A PARTNERSHIP APPROACH
The go-live phase of an implementation is arguably the
most important time period in the process. If there are
any software problems, the practice may be at risk of not
being able to see or treat patients until the technology
issues are resolved. Additionally, if there are “blind-spots”
during rollout, many organizations will have to go back
and resolve problems later down the road, resulting in an
even longer time period of decreased productivity. Having
highly experienced support experts present during the
implementation ensures that software problems can be
fixed immediately without disrupting daily operations.
Based on training recommendations from the Washington
and Idaho Regional Extension Center (REC), practices
should look for a vendor whose standard implementation
process includes sending an expert team to provide hands-
on, technical and clinical expertise to ensure there are no
software roadblocks or workflow problems that might
prevent the practice from operating at peak efficiency as
soon as they go live. Before the team leaves the practice,
their commitment should be to ensure everyone is able
to effectively use the charts and templates they helped
create, that the practice is operating smoothly with the
new system and that everyone’s questions have been
thoroughly addressed. The ability to provide this level of
personalized support and on-site technical troubleshooting
is a key component that Nextech customers often mention
as standing in stark contrast to their experience with big
box vendors.
Solutions and Personalized Training
A truly customizable solution
should utilize flexible templates to
customize charting and workflow
to meet the needs of every user
within a specialty practice.
Having highly experienced
support experts present during
the implementation ensures that
software problems can be fixed
immediately without disrupting
daily operations.
The ability to provide this level
of personalized support and on-
site technical troubleshooting is
a key component that Nextech
customers often mention as
standing in stark contrast to their
experience with big box vendors.
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FINAL TAKE-AWAYS
FOR SELECTING AN EMR VENDOR
Selecting an EMR is more than choosing a list of
functionalities. Providers need to ensure that the system
fits in with their workflow and day-to-day operations. When
a system is personalized and tailored to fit the unique
demands of a specialty practice, it can become a powerful
tool that not only drives improved care and efficiency, but
also supports business goals through marketing modules,
inventory control, imaging capabilities and mobility,
to name a few. It is imperative that providers take time
selecting the EMR that is right for them and that they make
sure their vendor is committed to supporting them not
only during implementation, but for the long term success
of their practice.
Choosing the Right EMR
FULLY INTEGRATED
MOBILITY
Mobility and efficiency are even more
critical with the higher patient volumes
compared to generalist counterparts. DON’T BE BOXED IN!
Don’t Settle for the rigidity of a
Generic Big Box EMR!
DON T BE BOXED IN!
One Size Only
One Way Only
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1. New IDC Health Insights Survey of Ambulatory Providers Reveals Dissatisfaction with Ambulatory EHR . Retrieved from http://www.meddatagroup.com/idc-health-insights-report-ehr/
2. http://www.healthcare-informatics.com/news-item/ambulatory-providers-dissatisfi ed- ehr-systems-survey-reveals#.UuAa2xAMexw.email
3. http://www.meddatagroup.com/idc-health-insights-report-ehr/
4. EHR divorce: What’s driving dissatisfaction? Retrieved from http://medicaleconomics.modernmedicine.com/medical-economics/news/ehr-divorce-whats-driving- dissatisfaction-0?page=full
5. http://medicaleconomics.modernmedicine.com/medical-economics/news/ehr- divorce-whats-driving-dissatisfaction-0?page=full#sthash.ifQXCMCU.dpuf
6. http://www.rand.org/content/dam/rand/pubs/research_reports/RR400/RR439/RAND_ RR439.pdf
Provider for your Practice
“Use this as an
opportunity to
think very carefully
about what your current
workflow is and how
information technology
can be optimized to
leverage your work
processes.”6
Before jumping full-force into the search for an EMR, make sure
you have put together a thorough synopsis of what your practice
needs from the system of choice. Create a list of these key items
and use it as your scorecard to qualify potential vendors. By doing
so, you are defining a standard for your practice and will be able
to methodically approach the task of finding the most suitable
solution to help your practice thrive and grow.
What do you need?
Marketing
Patient Portal
Patient Engagement
ONC Certified
ICD-10 Compliant
Mobility
Practice Management
Electronic Medical Records
Billing
Inventory
Revenue Cycle Management
Analytics
SPECIAL PRACTICES = SPECIALIZED NEEDS
KNOW YOUR NEEDS
Nextech deploys specialty-focused healthcare technology
for physician practices. As a trusted advisor to thousands of
specialty providers since 1997, Nextech delivers consultative
guidance, professional services and innovative tools that
enable clients to increase efficiencies while meeting their
long-term business goals. The company’s robust solutions
integrate seamlessly with value-added modules to create
a single, intuitive platform that streamlines clinical,
administrative, financial and marketing workflows.
To learn how Nextech’s advanced offerings help
specialty providers succeed in a fast-changing
healthcare environment, visit www.nextech.com.
5550 West Executive Drive, Suite 350 || Tampa, Florida 33609 || p: 866.857.8557 || f: 813.425.9292 || Nextech.com