Physician practices we've seen succeed with EHRs are those that focused on core functionality first. Here are five areas to concentrate on:
1. Patient registration. This includes staff entry and patient entry through patient portals and kiosks.
2. Scheduling. This isn't just for patients, but also for physicians, equipment, and resources.
3. Clinical documentation. This includes physician, nurse, and medical assistant documentation; testing and treatment order templates; decision support alerts for key conditions and treatment; and quality/outcome reporting.
4. Accounts receivable. Analyze charge capture, claim submission, and insurance payment postings; patient statement and payment postings; and management reporting.
5. Communication and care collaboration. Consider the ability to support the consult, referral, and care transition among caregivers; patient communication (secure e-mail, telephone calls, remote monitoring devices); tracking and handling of paper communication, such as mail and faxes; handling of medication history, formulary, eligibility, and electronic prescribing; electronic exchange of reports and results; and secure access to EHRs from handheld devices.
At Huntington Memorial Hospital, we're conducting seminars and providing educational resources, such as EHR selection toolkits. We're also offering an e-prescribing application that encourages physicians to take small steps into technology adoption, while providing them breathing room to evaluate and implement the right EHR systems for their practices.
In addition, we're building IT infrastructure that supports information sharing among multiple sources in a variety of formats, and puts information into a uniform structure so it can be shared with other electronic health records, personal health records, and decision support systems. Our goal is to make sure collaboration among inpatient, outpatient, and private practice settings occurs in what we refer to as "high definition"--in terms of detail, contrast, and refresh speed. That's needed to support fast, informed decision-making at the point of care, to improve the quality and lower the cost of care.
Hospitals have a license to house patients; physicians have a license to treat them. It's only by hospitals and physician practices working together, and adopting the right tools and processes, that we can meet the healthcare needs of our community.
Together with physicians in our community, we care for more than 11,000 people a day--10,000 of them in the private physicians' offices. We consider community physicians somewhere between a national treasure and a natural resource and want to make sure they don't become an endangered species. Creating a collaborative virtual health community that improves quality of care begins with physician engagement as much as it does adopting the right tools and processes. We hope with our encouragement and assistance that community physicians don't just survive, but thrive.
Rebecca Armato is executive director for physician and interoperability services at Huntington Hospital in southern California. Write to us at [email protected].