EHRs: AAO Keeps Its Eye on the Ball

I’ve written frequently about the unique needs of specialists and how these have been overlooked by the government and by EHR vendors. Since many ophthalmologists are heading off this week to the AAO (American Academy of Ophthalmology) Annual Meeting in Orlando, I thought it appropriate to comment on the proactive advocacy and advisory role that this particular professional society has adopted on behalf of its members, and to encourage other academies to step up their efforts similarly.

EHRs: AAO Keeps Its Eye on the BallAAO has been quite active on the meaningful use front. This week’s HIT Policy Committee’s Meaningful Use Workgroup meeting focused on how make meaningful use more meaningful for specialists in Stage 3. AAO was one of only two specialty societies represented in the public comments at the end of the meeting—the Academy’s representative pleaded that measures irrelevant to ophthalmology be replaced with those that would add value for these specialists, and offered the Academy’s assistance to accomplish this.

In addition to providing its members with otherwise unavailable, ophthalmology-specific direction on how to meet meaningful use, AAO has also offered much-needed guidance regarding the selection of an appropriate EHR for ophthalmologists—meaningful use aside. Recognizing that their unique specialty-specific workflow and data needs are not effectively addressed by most EHRs—because of the typical primary-care focus—AAO charged its Medical Information Technology Committee with the identification of a set of ophthalmology-relevant EHR specifications. A group of authors led by Michael Chiang, M.D., identified a set of features and attributes that ophthalmologists would find particularly valuable, and published their recommendations in an article titled “Special Requirements for Electronic Health Record Systems in Ophthalmology.”

While features and functionality are important, feedback from colleagues who actually use the EHRs is even more critical. The advice that AAO has given its members on how to make the most out of site visits will serve all physicians well, regardless of their specialty, and I am therefore sharing it with you below. It is reprinted from the publication “Electronic Medical Records: A Guide to EMR Selection, Implementation, and Incentives.”

ASK COLLEAGUES THE RIGHT QUESTIONS:

  1. When did you install your EMR?
  2. How long was the installation/implementation process?
  3. How would you describe the installation/implementation process?
  4. Was the system as user-friendly as the demonstration by the salesperson?
  5. How many patients per hour/per day did you (and your partners) see before the installation/implementation of your EMR?
  6. How many did you see after?
  7. Approximately how much more time do you devote to entering exam data into your EMR now compared to how you documented exams before you began using an EMR?
  8. How do you like the quality of the EMR-generated exam notes?
  9. Have you had to hire scribes to enter data for you? If so, how many and what is their annual cost?
  10. Has your EMR completely eliminated the paper charts in your practice?
  11. Given your practice’s experience with your EMR, would you recommend it to a similar practice?

EHRs are here to stay, and will play an increasingly important role in medical practices. A major investment, EHRs can dramatically impact practice operations and productivity—positively or negatively. It is my hope that, like AAO, the medical academies will use their clout and speak out more aggressively to protect the interests of their members.

5 thoughts on “EHRs: AAO Keeps Its Eye on the Ball

  1. when will EHR be mandatory? I need to know so I can plan to close my office. I can not earn a living now and will not pour more money down a “hole”

  2. They will never be mandantory. The question is do you want to give up the incentive money and later be subject to a POSSIBLE penalty of 1-2% of your Medicare revenue. You have until October 1, 2012 to start “meaningful use” if you want to get your hands on the full $44,000. The first year you will get $18,000 but it decreases every year thereafter and after 4 years there may be a penalty. Some people think the penalty will never be instituted. The $44,000 is a simple inducement. In the end, it will cost far more than $44,000- factor in closing office for training, extra employees, hardware, software support, etc.

  3. Be leary of the promises & sweet sales talk of an EHR vendor. I was convinced by the sweet talking sales rep of MD LOGIC that their system will be an easy transition to paperless office & that he promised that their EHR can provide everything ophthalmology needs. It was all a lie. I lost more than $ 90,000.00.

  4. I’ m 77, still practicing FT as a ped.ophthalmologist. I have looked at a number of systems and there is not one that suits my purposes. They are way too complicated and inappropriate, being based on primary care practice, or because they are “interacting” with every piece of equipment known to man. They slow me down and hinder my interaction with the patients, who see more of my neck than my face, which certainly is not good for pediatric patients. On top of this, I have seen no convincing evidence that the EHR is any more accurate than my written one. And the templates, often written in atrocious English, force you into a specific frame work, with little room for deviations from the norm. At this point I have a lot more confidence in my stubby pencil, than in these expensive electronic systems. That the government is cramming this stuff down our throats, adds insult to injury.

  5. We considered the AAO’s support of [Vendor Name Omitted] software ([Omitted] is designed particularly for Ophthalmologists) prior to contracting with them and it is quite obvious that no Ophthalmologist was involved in the software development at any time. Any suggestions/concerns/complaints are met with “that is how the system is programmed. It cannot be changed.’ We attested early in January 2013 and were told we ‘passed’ and should receive our check by the end of January. We were then told it would arrive by the end of February. We then received notice that we were selected for an “audit.” The audit takes up to 60 days. [Omitted] then sent out a 30 page directive on how to “manage the audit.” Apparently, many of their Ophthalmologists who attested received the same payment delay notice we did. Obviously, we are not expecting payment any time soon. Please contact us if you are considering [Omitted].

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