From an EHR Newbie.....

[jerry]

Hi, folks.....Been experimenting with the EHR module, and plan to go 100% electronic records on 1-2-17. Quick and easy questions for you guys: Do you suggest I keep concurrent paper records also? Do you take the time to import your Optomap photos, fields, et al into the patient's record, or just leave them in their own respective folders? TIA, Jerry

[drmarkod]

Just do it, and use the EHR the way it is designed. You will be slowed down enough in the first few days going live with EHR, and you don't need the added work of doing a paper chart. On the other hand, before we went live, I took several of my paper charts and entered them into the EHR to make sure it was at least comparable to my paper charts.

As far as importing pics and other data, you have to look at it in terms of whether or not the data will always be accessible in the future. I have heard that with certain equipment, if you terminate your lease, you can't get to your prior data. The other consideration is that native software usually allows you to manipulate the data in different ways, while pulling it into the EHR will give you a single snapshot of the data . If it's not too much work, I don't think you can go wrong with putting the data into the EHR. You might still prefer to use the native instrument's software for review, but you will always have a backup.

Mark

[mjhervey]

When we went live, we had assigned staff member scanning in previous info prior to patient's coming in. Initially paper chart followed patient (1st exam with Crystal).

[mdeyedoc]

Dec 5, 2016 21:56:52 GMT -6 jerry said:

Hi, folks.....Been experimenting with the EHR module, and plan to go 100% electronic records on 1-2-17. Quick and easy questions for you guys: Do you suggest I keep concurrent paper records also? Do you take the time to import your Optomap photos, fields, et al into the patient's record, or just leave them in their own respective folders? TIA, Jerry

No, go to EHR but make sure your template has good bones. You can always modify it as you go but if it can't handle the basics you are going to have problems and you really don't want to change templates unless you have to. Versioning is a last resort IMO.

Take at least 10 charts representative of your typical patients and enter them. Then go back and do a return exam. Entry on a return exam is different from a new exam where you don't have any data or you can refer to their previous paper chart. Make sure you can access the info you need. Keep a notebook close by and make note of any time you don't have easy access to what you need to know and update the template when you get a chance. I would not scan paper charts until the patient shows up for a complete exam. IMO, it's much easier to review a paper chart, at least until you get all their basics fields populated.

This won't help much until you are seeing patients back but remember that you can run multiple copies of Crystal at one time. Sometimes it's a lot easier to look at a patient's previous records in a separate window instead of going back and forth between dates on the med rec tabs. 

I don't save images and testing into Crystal. I have links to the software within Crystal so I can open the native testing software to the patient and view what I need to view there but I could see where that could be an issue if your contract locks out future access.  Seems like there should be some kind of protection against that when we are supposed to keep records for 7 years but the equipment guys have a racket.

Good luck!

Marcia

[friscoeyeassociates]

I would not use concurrent paper charts, as it would be totally redundant. If you are concerned about implementation then I would maybe do a "soft" opening with it the week before the new year. Have an afternoon or evening after you close where everyone in the office gets their exam done, and maybe family members too, and this will give you a nice trial run for EHR in a live setting. We did this over a decade ago when we first switched to EHR, and we did it again 2 years ago when we switched to Crystal.. Immensely helpful on both occasions. 

As far as storing the images, I am not sure how your network administrator has set up your office. Optomap photos are fairly data heavy, and while there is some value in being able to reference a photo from the files page, you would not have the controls to adjust the settings on the image that allow you to see all of the different layers.. These are valuable tools and for that reason I think it is best to use the software designed for the photos when reviewing them... Also, we all pay a handsome amount of money every month to lease a machine from Optos, and bypassing the review software for the ease of having it in the files tab seems like it would be cannibalizing some of the value of what you paid for. I also think it is nearly as fast to link to the review software if you design a button for your record to get there in one click. It is my understanding that you will still have access to the photos through their software even if you cancel your lease, and of course you can always download your photos to external hard drive for back. The photos are yours. If you do use physical backups like this, you MUST be extremely cautious about Security and limit access to them for example regular staff members should not have access to them, only a select few who it could be argued SHOULD have access to them.. HIPAA is pretty strict about these things. 

We do scan VF/OCT reports into patient chart. The reason being because 1) they don't require proprietary software to be 100% functional and 2) Because we don't pay for any of the other image organizing softwares out there like Zeiss' FORUM. 

[jerry]

Thank You, everyone, for your thoughts. Every one was helpful. Jerry