Value-based care continues to ramp up. Are your practice’s operations keeping pace? Believe it or not, your EHR can help you succeed under value-based care—if you know how to put it to work. In our last post, we detailed how your EHR can help clinicians improve patient care and safety. In this post, we’ll review three more ways your EHR can help, not hinder, your practice’s transition to value-based care.
Not only does the EHR allow physicians to track a patient’s existing conditions, but it can also help practitioners diagnose new conditions, since the EHR makes it easy to track a patients’ trends over time.
“I’ve been in situations where my ophthalmologist or optometrist was actually the one who discovered that a patient had diabetes,” Holt says. “The saying ‘the eyes are the window to your soul’ really is true.”
If that happens, the physician will record and document all of the information that led them to believe the patient had diabetes, and will then ask the patient about their most recent primary care visits.
“The ophthalmologist will share the findings with the patient and say they think it may be diabetes-related and can refer the patient to a primary care physician,” she says. The practice can then send a letter to the primary care doctor along with the findings that were documented in the EHR, so that primary care physician can have optimal information when he sets up a visit with the patient for further evaluation.
Maintaining Continuity of Care
When patients think about eye care, they focus on the eyes. As an eye care provider, you know that what you do can impact the entire body.
“The EHR is a way to be able to not only track eye health but also to easily communicate the information from each visit to the patient’s primary care physician and other providers,” Holt says. Any time the ophthalmologist sees a diabetic patient, for instance, the eye care practice would send a letter to the PCP explaining that visit’s findings. “For continuity of care and value-based medicine, that’s essentially going to be necessary in the future no matter what, so it’s a good practice to get started now,” Holt says.
The same goes for patients with other conditions, like heart issues. “Eye care practices typically send information to patients’ cardiologists with the day’s findings just because if, for instance, they have retinopathy, the eye care physician wants the cardiologist to know that there’s a potential for surgery. That would be important for the cardiologist to be aware of,” Holt says.
Michal V. Borland, MD, PhD, drives home this point with a story he shared during an EHR safety panel discussion at a previous AAO conference. It involved a patient who discontinued her anticoagulants before cataract surgery. After the surgery, no one told her to re-start her meds, and she had a stroke in the post-op period. A stroke that—had the right information been communicated to the right person—could have been avoided. need to make sure there is explicit communication with the PCP to make sure these types of details are discussed with the patient, Borland recommends.
Helping Future Patients
It sounds a bit, well, futuristic, but in addition to helping your current patients achieve better health outcomes, your EHR could assist future patients. Because insurers and other entities collect data reported via your EHR, analysts can model the insights gleaned and predict future problems or create illness patterns. This can help from a public health perspective so future issues can be anticipated and care can be administered where it’s needed most.
Optimize Training to Focus on These Perks
Once you understand all of the ways your EHR can help improve patient care, you must work with your EHR vendor and staff members to implement any necessary updates so your software can accommodate all of the information (fields) you want to include. Staff and providers may need additional training to ensure all the right information is accurately captured.
“With the way MIPS is moving forward, in order to qualify for incentives, the information must be documented within EHRs,” Holt says. “When practices fall short, it’s usually because they didn’t document the review of systems appropriately or revisit that ROS to track specific conditions,” she adds.
For instance, if the physician documents uncontrolled diabetes in May, he or she will want to remember to document whether it’s still uncontrolled when the patient returns six months later in November. “A lot of it is just following up with questions to make sure you’re tracking those conditions, and that’s where some providers slip up,” Holt said.
The bottom line: Your EHRs have capabilities that can enhance patient care and improve outcomes—you just may not be using those capabilities to their full extent. If you have trouble figuring out how to incorporate these processes into your office’s system, contact your EHR vendor for help. Many EHR user interfaces make it all too easy to make little mistakes that add up to a real problem. The goal is to make it easy to do the right thing, and impossible to do the wrong thing,” Borland says.
Take the ONC’s Advice
The government’s Office of the National Coordinator for Health Information Technology (ONC) offers advice to practices on how to optimize their EHR to improve patient care. Check out the ONC’s tips on ensuring you make the most of your EHR:
When the physician uses an EHR, he is able to see the patient’s complete health information, offering a comprehensive picture that can help diagnose issues more quickly.
Watch for Medication Issues
Although you already know your EHR keeps a record of your patients’ medications and allergies, you may not realize your system can automatically check for problems and alert the doctor if a new prescription is ordered that may conflict with existing medications or allergies.
Other Physicians Can Access It
If your patient visits an emergency department, it can typically pull up the information in your EHR so the ED physicians are aware of any issues straight from your clinical record.
Source: Improved Diagnostics and Patient Outcomes, https://www.healthit.gov/providers-professionals/improved-diagnostics-patient-outcomes