EMR BIG BOX DISSATISFACTION Pushes Demand for Specialty Specific Systems

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1 WHITE PAPER EMR BIG BOX DISSATISFACTION Pushes Demand for Specialty Specific Systems ONE SIZE DOES NOT FIT ALL

2 General Practice EMR Dissatisfaction Pushes 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. 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. 1 Nextech.com

3 Demand for Specialty Specific Systems TOP REASONS SPECIALTY PHYSICIANS WERE DISSATISFIED WITH THEIR EHR: SPEED of Documentation and PATIENT VOLUME 85% Spending more time on documentation 2 66% Seeing fewer patients 3 58% Specialty physicians said they were dissatisfied with their system s usability OTHER RESULTS FROM THE SURVEY INCLUDE: 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 % in 2012 were dissatisfied with the EHR s ease of use TOP REASONS SPECIALTY PHYSICIANS WERE SATISFIED WITH THEIR EHR: DOES YOUR SYSTEM WORK WITHIN YOUR WORKFLOW? 82% Reduction in the number of lost or missing charts 75% The ability to access medical records and work remotely 56% Incentive payments Accessing Patient Information Documenting Care eprescribing Viewing Labs and Diagnostic Tests Results Entering Orders Nextech.com 2

4 Integrated Software Solution 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 revenueto-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, 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. 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. 3 Nextech.com

5 Anytime, Anywhere Access practice management patient engagement emr marketing CUSTOMER RELATIONSHIP MANAGMENT inventory analytics revenue cycle management Nextech.com 4

6 Every Minute Counts: Solutions Made 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. 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. 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. 5 Nextech.com

7 with Specialists Time in Mind 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. 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. Big Box v. Practice-Specific THE BIG PICTURE 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. 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 Nextech.com 6

8 Preparing for Success with Customized 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. The ability of the software to map to physician s personal preferences greatly enhances their satisfaction of the solution. 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. 7 Nextech.com

9 Solutions and Personalized Training 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. 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. 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 handson, 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. The ability to provide this level of personalized support and onsite technical troubleshooting is a key component that Nextech customers often mention as standing in stark contrast to their experience with big box vendors. Nextech.com 8

10 Choosing the Right EMR 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. DON T BE BOXED IN! MOBILITY Mobility and efficiency are even more critical with the higher patient volumes compared to generalist counterparts. One Size Only One Way Only Don t Settle for the rigidity of a Generic Big Box EMR! FULLY INTEGRATED 9 Nextech.com

11 Provider for your Practice KNOW YOUR NEEDS 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. 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 What do you need? Practice Management Electronic Medical Records Billing Inventory Revenue Cycle Management Analytics Marketing Patient Portal Patient Engagement ONC Certified ICD-10 Compliant Mobility SPECIAL PRACTICES = SPECIALIZED NEEDS 1. New IDC Health Insights Survey of Ambulatory Providers Reveals Dissatisfaction with Ambulatory EHR. Retrieved from ehr-systems-survey-reveals#.uuaa2xamexw EHR divorce: What s driving dissatisfaction? Retrieved from dissatisfaction-0?page=full 5. divorce-whats-driving-dissatisfaction-0?page=full#sthash.ifqxcmcu.dpuf 6. RR439.pdf Nextech.com 10

12 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 West Executive Drive, Suite 350 Tampa, Florida p: f: Nextech.com