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Is A Paperless Office Really Possible?

 
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Peter Polack

It is always important that your practice understands what it wants from an electronic medical records (EMR) solution. What are your practice's goals, and what are your priorities? Ask yourself some of the questions below:

Do you wish to make the practice more efficient?
Are you preparing for 'pay-for-performance' reviews?
Do you desire a paperless office?
Are you anticipating a future where electronic records are mandatory?
Is any of this even possible?

A challenge we faced when moving from a paper-based office to an electronic one: what will we do with the various paper-based forms in use at our practice and surgery center? Some of these forms are required by federal and state agencies; others are simply in common use at the practice over the last thirty-five years.

Really, we have so many forms that we don't know exactly how many. We are compiling a binder, to help us determine which forms are necessary, which gather duplicate information from other forms, and which are used so rarely that we can do without them.

As our goal is to input as much documentation as possible into the EMR system, many forms will need to be made into templates which are filled out electronically. Creating custom templates costs time and money; you'll have to choose which forms you need to incorporate into the EMR system and which will be filled out manually, on paper.

However, these paper-based forms will next need to be scanned into the system, then saved as images. The downside to this sort of 'scanning' solution: the data which is stored in this way has limited use. This 'read-only' information isn't easily accessible for data mining or research. However, some practices that run on an EMR system have discovered that using some paper forms can be integral to overall workflow - they are shredded at the end of the day, after use.

A way to lower your amount of paperwork without having to implement a full EMR system is by using e-Prescriptions (available in some practice management systems). Prescriptions are sent to the patients' pharmacies electronically, without the need for a physician to search for a prescriptions pad to write out the prescription manually.

Also consider communications between medical practitioners; many won't be ready for EMR in the near future. It's currently estimated that about 7 to 10% of medical practices are using EMR. Many systems are able to create a document from the clinical examination, which can then either be printed and sent by post, or transferred electronically to a referring doctor by fax, as an example. The legal guidelines for sending medical information by email have grown increasingly complex, requiring another lengthy column to discuss.

Even if you're scanning all paper-based records into digital format, still you may not completely eliminate the use of paper at your practice. Many forms of paper records must be kept for legal and regulatory reasons. No need to sell the file cabinets quite yet. It could be a long while before we see the day when all documentation was stored electronically.

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Peter J. Polack, M.D., F.A.C.S., is founder of emedikon, a medical practice management consulting firm and president of Protodrone, a software development company specializing in medical practice applications. See: http://www.medicalpracticetrends.com for more info.
Article Tags: emr [See Dictionary], forms [See Dictionary], practice [See Dictionary]
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Article published on April 22, 2009 at Isnare.com
 
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