Making EHR work: how smart text and templates help ophthalmologists

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In her 30-year career as a health clinic administrator and manager, Debbie Stepner has seen and heard the blessings and curses of EHR.


Because EHR systems attempt to cover fairly universal needs, they are sometimes short on specific adaptability for specialists. For example, Stepner’s ophthalmology team at DMA found that their paper system served them much better than their EHR system. Non-electronic files can include, for example, images of the back of the eye. “A paper chart can include anything you want,” Stepner noted, with its images instantly available and easy to read.


The ophthalmologists were not happy with EHR. They felt they were being pushed into using a system that didn’t support these vital documents.


…but we can adapt if given the tools


So, DMA purchased an ophthalmology module for their EHR system. Stepner likes the interface, as do most of the ophthalmologists at her practice; it includes everything that paper charts do. But the doctors approach it in different ways.


One ophthalmologist in particular takes full advantage of the software’s smart text feature; the retina specialist has added specific terminology to further expedite note entry. DMA’s EHR-dedicated IT team handles requests for template and smart text customizations.


The software is more time-consuming for doctors to enter their notes, Stepner admits; the smart text helps, but there is still some pointing, clicking and typing to do. Some doctors don’t complete the chart for as long as a week or two, being short of time. The above-mentioned ophthalmologist is diligent about sitting down and completing all her notes from each encounter immediately after each patient leaves, before seeing the next one.


This puts her under great time pressure, lest she lag too far behind her patient schedule. “But, at the end of the day—she’s done,” says Stepner; the patient’s record is up to date, the billing is out of her hands, and she doesn’t have a backlog hanging over her head.

The delay caused by the time-consuming software could also affect the clinic’s bottom line. The EHR system automatically sends information to the billing department; the charge drops and the appropriate insurance company is billed. So, the longer a doctor takes to complete patient encounters, the longer the clinic has to wait to get paid for services.


More and more, Stepner says, the doctors and staff at DMA are coming around to appreciating the benefits of EHR, particularly as better features are introduced. “There’s a downside to everything,” she says, but “truthfully, it’s better to have EHR.”

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