How can orthopedic EMR software improve productivity?

Any change in daily office routine can be difficult, but implementing electronic health records can be a challenge like no other. This is no more evident than in orthopedic offices, where multiple teams of doctors have to see one patient, which can give rise to patient flow difficulties as everyone attempts to coordinate.

Harmonizing radiologists, orthopedic technicians and bracing specialists as well as clinicians and physicians is chaotic enough, but when a new EHR system is added to the mix, then office managers need to get really creative.

Big changes for big practices 
Over the past few years, the Center for Orthopedics, an orthopedic medical group practice in a suburb of Cleveland, Ohio, has struggled to make effective use of its new EHR software. The Center for Orthopedics employs six orthopedic surgeons, one non-surgeon physician, five physician assistants and a combined staff of over 60 people, and they treat approximately 20,000 patients per year.

Back in 2012, Sheila Tonn-Knopf, director of the Center for Orthopedics, saw that as their program expanded, they would need to find new ways of managing all these patients, procedures and professionals. To help the center direct its patient flow more effectively, she implemented new orthopedic EMR software that was meant to help {…? end of sentence?}

However, at first, Tonn-Knopf thought she might have made a huge mistake. When the Cleveland-based practice first brought in EHRs, office productivity dropped by 50 percent. Everyone, from the patients to the doctors and secretaries, struggled with the logistics of learning new software while maintaining business as usual.

The doctors and technicians found that the time they spent entering information into their EHR system was detracting from the time they should be spending with patients. As a result, workflow ground to a halt and both patients and doctors found themselves either rushing or waiting, and wasting a lot of time trying to figure out EHRs in between.

Sharing data entry 
One of the biggest problems with this system, as Tonn-Knopf observed, was that too much of the burden of data entry was placed on the doctors. This slowed them down and distracted them from their primary objective of tending to the patients. She realized that one of the benefits of the old paper system was that a lot of the burden of data entry was placed on the patient.

For years, patients, new or old, would have to fill out a form every time they came to the office that included information like symptoms, concerns, health habits, etc., and that information would go in a folder that would be put in the patients' files. However, EHRs are not that simple, especially when held to the standards of meaningful use.

Meaningful use hurdles 
Meaningful use, which is part of the incentive program offered by the Centers for Medicare and Medicaid Services, requires doctors to capture and report data in order to demonstrate that their EHRs are being used in more than just a nominal fashion. In return, practices that can successfully attest to meaningful use requirements are eligible to receive financial incentives.

However, this program also necessitates that doctors collect information on general health trends, such as smoking cessation, which is not data that would normally be relevant to the everyday practice of orthopedic medicine.

Software solutions 
However, the Center for Orthopedics found a solution to this problem in data entry assistance software that allows patients to fill out intake forms with a special pen. Due to nearly invisible codes and markers unique to each patient, which are embedded into the paper, completed intake forms can then be put into the computer. The patient-entered data will then be incorporated into their EHRs, and follow them throughout their diagnosis, treatment and recovery progress.

By reallocating some of the responsibility of data entry from doctors, secretaries and assistants to patients, the Center for Orthopedics was able to significantly improve its efficiency. This also allowed doctors to focus on becoming deeply familiar with their end of EHR data entry. Doctors were able to get past their EHR updating responsibilities more quickly and focus on their patients more intently. Eventually, the Center for Orthopedics turned its efficiency deficit around. Within a few months, it went from 50 percent productivity to 100 percent productivity and beyond.

Learning new tools 
Several years after this transition, Tonn-Knopf noted that technology is good, but it is not the be-all and end-all. Reflecting on her office's adoption of EHRs and data entry programs, she claimed that "a technology solution is only as good as understanding and implementation." She continued by saying that the EHRs and intake form programs were great "silver bullets," but they have to be used in the right context.

Essentially, it is one thing to buy a fancy new piece of software, but for it to be useful, people need to know how to make it work for them. To follow up on Tonn-Knopf's metaphor, silver bullets are great, but health care professionals need to know how to aim and shoot if they expect to hit their targets.