Electronic Medical Records (EMR)

 

From Dr. Molly Stout

• Store protocols (EMA) and dot phrases (Epic) for your frequently used visits
  
• Take the time to train your medical assistants and nurses to be comfortable with adding items to the EMR - it’s a team effort!
• The “diagnosis comment” plan on EMA is one of my favorite functions for adding history and/or my thought process without it ending up on the patient’s after-visit handout 
• Make a printed document of favorite sunscreens or skincare products so you can provide these to the patients if their handout isn’t ready yet 

 

From Dr. Cather McKay 

 

Investing time up front to train staff on my charting preferences helps me spend less time on documentation outside of clinic. When I see common mistakes being made that take me time to correct or when there are CMS coding updates, I send out a message or have a short meeting to review. I also have a preference sheet for staff to reference if needed. When new nurses or MAs start, they are trained by other staff, but I try to review their notes with them at first. Explaining why certain details are important, such as including a BSA or PGA score to get biologics approved, helps them to remember to do it each time. While I usually feel far from efficient, correct documentation by well-trained staff helps tremendously.

 

 

 

From Dr. Shawna Flanagan

 

Whichever electronic medical record you choose make sure the company has great support and customer service. I have personally been using EMR for 20 years. It has evolved but I prefer my smaller, customizable EMR, initially known as Medi notes when I began using it in 2003. Over the past twenty years it has been bought and merged and now is known as IMS (Intelligent Medical System). Make sure your EMR system has the capability to help you comply with MIPPS and MACRA and make it as easy as possible to submit to Medicare for your highest reimbursements. Also make sure the EMR you chose has practice management software or a compatible one for scheduling, billing, cosmetic billing and inventory and other practice management needs.

 

When I have been tempted to change over the past few years, I have gotten competitive quotes and demos from other EMR systems out there and negotiated my fees.

 

The fees and headaches associated with EMR are unfortunately going to be a necessary evil as the government continues to dictate the practice of medicine through its Medicare rules and regulations. Despite the headaches and hassles, I can’t even imagine going back to paper charts! It seems so 1999!

 

 

 

From Dr. Susan Massick

 

It is easy to drown in EMR-- try to do as much in real time as possible to avoid the dreaded overflowing inbox. I use EPIC, so the terminology may be more specific to EPIC users, but hopefully these tips will extend to other EMR platforms.

Build your “smartphrases” early on, edit them, and keep adding as new treatment plans emerge. Have specific phrases for the diagnosis, the physical exam, and the treatment plan with *** markers to fill in with specifics for each patient.

 

Name your smartphrases something easy to remember and simple to type. I used my initials, which I found out the hard way is short for “sternocleidomastoid” that constantly pops up.

 

Use your MA/nurses as scribes in the room if possible.

 

Try to have as much auto-populated into your notes as you can so your EMR does your work for you. Associate orders with the diagnoses, so they auto-populate into your note.

 

If you have MyChart system where patients can send you questions: You likely already have patient instructions for your go-to treatment regimens (ie, acne topical regimens, bathing techniques for eczema kids, protocol for applying 5-fluororuacil to Aks, etc)—have similar first-line responses to frequently asked questions that your nurses can send to your patients. To streamline or eliminate back-and-forth messaging on patient inquiries, provide your staff templates with questions to pose back to patients to gather as much pertinent information needed to provide helpful answers.

 

 

 

 

 

 

The Women’s Dermatologic Society (WDS) News You Can Use Committee supports Dermatologists at any stage of their career looking to manage or start their own practice by offering resources on navigating the practice environment. Visit the WDS blog for more tips and advice.