ASE 5: SELECTING AN EHR FOR DERMATOLOGY PRACTICE Suppose you’ve just been hired as the practice administrator of an eigh
Posted: Sun Jul 03, 2022 5:21 pm
ASE 5: SELECTING AN EHR FOR DERMATOLOGY PRACTICE
Suppose you’ve just been hired as the practice administrator ofan eight- physician dermatology practice. After several years ofcontemplation and serious deliberations, the physicians have madethe strategic decision to invest in the selection andimplementation of a facility-wide EHR system. They also want toreplace their practice management system (which includes patientscheduling and billing). It’s an older system that is ratherclunky. Ideally, they’d like to find an integrated practicemanagement system that has an EHR component.
Dan Brown, the current CEO of the physician organization, hasvery little knowledge of information systems technology. He hasbeen reluctant to move toward an EHR system for many years,primarily because he heard stories from a few his colleagues inother specialty areas who have implemented EHRs in their practicesand have found the systems to be highly cumbersome and disruptiveto the patient care process. One of his best friends claims he“spends an extra hour or two a night in the office because of theadditional time demands of the EHR. He claims the system neverseemed to work right.”
CASE 5: SELECTING AN EHR FOR DERMATOLOGY PRACTICE · 481
Brown is convinced that there are not any greatdermatology-related EHR products on the market, but withvalue-based payment looming, and the opportunity to improve qualityof patient care, he’s open to taking another look. In addition, oneof their newest partners, Pam Martin, just finished her residencyprogram where EHRs were an integral part of her training. She is abig champion of the effort to select and implement an EHR. She hasoffered to help lead the effort. One of the other partners, JohnHarris, came back from a conference impressed with the vendorpresentation from Allscripts and con vinced it’s the way thepractice ought to go. The other physicians are nearing retirementand a little nervous about the possible disruption to theoffice.
Information Systems Challenge
Even though the patient records at the dermatology practice arepaper-based, the practice has been using computerized practicemanagement systems for patient scheduling and billing for years.Six months ago, they started to have a nurse enterphysician-dictated notes into the paper record while in theexamination room with the patient. The physician then reviews thenotes at the end of the visit or day and signs off on them. This isin an effort to decrease the dictation and transcription that thepractice had historically done and to get the nurses and physiciansready for the EHR. The expecta tion is that nurses will do thebulk of the data entry in the examination room while the physiciansare seeing the patients. However, the physicians will have toreview the documentation and sign off on all entries.
The practice currently has approximately four thousand patientvisits per month, including 40 percent Medicare and 10 percentMedicaid.
Discussion Questions
You are tasked with leading the team charged with the selectionof the new practice management system, including EHR, for thepractice.
You begin by convening a practice management–EHR selection team.Who would serve on the team? Who would serve as executive sponsor?Explain your rationale.
How might you conduct an EHR-readiness assessment for thispractice? What factors will be important to consider? Why?
Develop a draft system selection plan for this practice. What doyou envision will be the practice’s greatest challenges inselecting a replacement practice management system and a new EHR?Explain your rationale.
Suppose you’ve just been hired as the practice administrator ofan eight- physician dermatology practice. After several years ofcontemplation and serious deliberations, the physicians have madethe strategic decision to invest in the selection andimplementation of a facility-wide EHR system. They also want toreplace their practice management system (which includes patientscheduling and billing). It’s an older system that is ratherclunky. Ideally, they’d like to find an integrated practicemanagement system that has an EHR component.
Dan Brown, the current CEO of the physician organization, hasvery little knowledge of information systems technology. He hasbeen reluctant to move toward an EHR system for many years,primarily because he heard stories from a few his colleagues inother specialty areas who have implemented EHRs in their practicesand have found the systems to be highly cumbersome and disruptiveto the patient care process. One of his best friends claims he“spends an extra hour or two a night in the office because of theadditional time demands of the EHR. He claims the system neverseemed to work right.”
CASE 5: SELECTING AN EHR FOR DERMATOLOGY PRACTICE · 481
Brown is convinced that there are not any greatdermatology-related EHR products on the market, but withvalue-based payment looming, and the opportunity to improve qualityof patient care, he’s open to taking another look. In addition, oneof their newest partners, Pam Martin, just finished her residencyprogram where EHRs were an integral part of her training. She is abig champion of the effort to select and implement an EHR. She hasoffered to help lead the effort. One of the other partners, JohnHarris, came back from a conference impressed with the vendorpresentation from Allscripts and con vinced it’s the way thepractice ought to go. The other physicians are nearing retirementand a little nervous about the possible disruption to theoffice.
Information Systems Challenge
Even though the patient records at the dermatology practice arepaper-based, the practice has been using computerized practicemanagement systems for patient scheduling and billing for years.Six months ago, they started to have a nurse enterphysician-dictated notes into the paper record while in theexamination room with the patient. The physician then reviews thenotes at the end of the visit or day and signs off on them. This isin an effort to decrease the dictation and transcription that thepractice had historically done and to get the nurses and physiciansready for the EHR. The expecta tion is that nurses will do thebulk of the data entry in the examination room while the physiciansare seeing the patients. However, the physicians will have toreview the documentation and sign off on all entries.
The practice currently has approximately four thousand patientvisits per month, including 40 percent Medicare and 10 percentMedicaid.
Discussion Questions
You are tasked with leading the team charged with the selectionof the new practice management system, including EHR, for thepractice.
You begin by convening a practice management–EHR selection team.Who would serve on the team? Who would serve as executive sponsor?Explain your rationale.
How might you conduct an EHR-readiness assessment for thispractice? What factors will be important to consider? Why?
Develop a draft system selection plan for this practice. What doyou envision will be the practice’s greatest challenges inselecting a replacement practice management system and a new EHR?Explain your rationale.