Today's Practice: Changing the Business of Medicine | Page 12

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A Balancing Act
To avoid such frustrations, however, the EHR technology needs to meet providers’ needs while also
enabling complete accurate documentation in an
efficient manner. Many EHR software solutions
provide pre-defined templates that can only be
changed by the vendor or IT personnel. The idea
behind these templates is that they enable physicians
to quickly document clinical care. Other EMRs are
template free, allowing physicians to tell the clinical
story without using the various check-lists and boxes
found on templates. These allow physicians to tell
each patient’s story – without being limited to
certain pre-conceived notions.

Incorporate the Best of Both Worlds
For many practices, however, the best option incorporates the best of both worlds: It makes it possible
for physicians to use free text to create patient narratives but also enables them to use common problem
templates. With EMRs such as the one available
from RevenueXL, physicians use predefined
templates or forms to document very common and
repetitive procedures and visits and to speed up their
documentation efforts. And, they use free text to
ensure that the particulars of individual patient
stories are properly documented.
When evaluating a potential new system, leaders
should learn and test its capabilities, including how
all of its documentation templates work to ensure
they purchase an application that matches how they
want to structure their new documentation
approach.2
Scenario Testing or Walkthrough is Vital to Succeed
Practice leaders also should create scenarios that are
common to their specific practice and evaluate how
the technology would be used to fully document
them. For example, for documenting a new patient,
the practice should review various parameters in each
system they are evaluating including:

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Alok Prasad
How many steps are required to establish a new
patient record?
Is the process straightforward?
Does it accommodate non clinicians who might be
entering the information?
Do the screens flow logically?
Can they add additional information later?
How are outside tests handled?3
Practice leaders also should evaluate how the
potential EHR system would enable them to
handle other scenarios. For example, some parameters they should evaluate in documenting a
chronic patient recheck include:
How physicians would enter staff instructions for
preparations to seeing the patient;
How easily they could access updated lab results;
How they would be able to change existing prescriptions;
And how they would develop a new treatment plan.

Taming the Templates
Once a practice has selected an EHR, they should
further customize its documentation templates to
best meet the practice’s goals. For example, they
can rearrange the order of templates or dropdown
lists, or assign non-physician staff to complete
certain templates, such as demographic or vital
information.
It is also important for an EMR to support
template customization. Inflexible EMR templates
can easily pull an otherwise viable practice under.
With inflexible templates, doctors, nurses and

TODAY ’ S P R A C T I C E: C H A N G I N G T H E B U S INES S OF M EDI C I NE