Things Your EMR Will Never Do

EMRs can be powerful tools for building practice efficiency.

But they can’t do it all.

Ruth Sara Hart-Schneider, sales and marketing director for Cincinnati-based Salix, says health care providers are still paying too many people to move too much paper. Her firm helps them to fill the gaps left after even the most successful EMR implementation.
Ruth Sara Hart-Schneider is sales and marketing director for Salix
Salix specializes in workflow automation, business process outsourcing and litigation support. Health care makes up about 30 percent of its workload.

Hart-Schneider works with physician practices, hospitals and a variety of other health care clients, such as durable medical equipment firms and clinical research organizations. She deals with 26 EMR systems.

Note: If you catch her hanging out by your fax machine, don’t be alarmed. It’s part of her job.

Here’s what Hart-Schneider had to say:

Can you explain more about what your company does in health care IT?

We support health care companies in leveraging the electronic data they already have. We help them to avoid having redundant systems or people hand-filling forms or electronic systems generating paper systems. We work around the electronic systems in an office, like EMRs and practice management systems. Usually an office will have both, but there are all these other functions that have been left on the table.

What are some examples?

Most EMRs we deal with are not set up for prior authorization requests. And every state has its own forms for different programs — Medicaid HMOs, workers’ compensation. Particularly for practices dealing across state lines, it becomes cumbersome for the staff. EMR companies don’t want to program all these forms for all the states, and they change constantly anyway. That’s a sweet spot for us. Prescription monitoring is another one if the practice is giving many narcotics. Also, EMRs don’t interface with many of the tools the carriers have out there for eligibility, benefits and claims status. Some other areas are disability, return-to-work forms, immunization logs for pediatrics and certificates of medical necessity for things like wheelchairs and oxygen.

When practices invest in EMRs, do they realize how much they’ll still need to do on paper?

They’re trying to meet meaningful use. When they choose a system, they know what it will do. It’s not a tool to manage your office. Still, people get frustrated with how many repetitive tasks their employees have to do even after all this money has been spent. For example, a group had a pulmonary function testing machine that wouldn’t talk to the EMR. They would print the report and then walk over and scan it into the EMR. A lot of equipment is like that.

How do you identify the inefficiencies in a practice?

If you stand by the fax for 10 minutes and watch what comes through, you’ll have a pretty good idea. You can also look around at the stacks of paper. You can ask people what they’re behind on.

How do you help?

Salix will work with an organization to help them identify their biggest pain points and then customize a solution that will free up staff time and save them money. We look for the best tools for each application. We like FileBound, which has an ASP model product that meets all the HIPAA security requirements, has a very reasonable price point and allows unlimited users without user fees.

Among our services: We can help with the auto-population of forms, we can provide data-entry services for labs and test results that are faxed in and we can help provide interface solutions for equipment that’s not hooked to the EMR. For a surgery practice, as one example, we can help design and implement systems so that the manager can look at tomorrow’s schedule and ensure that all pre-certs have been completed.

How important is it to address these areas?

Most often, there are higher-level tasks that aren’t getting done because staff is bogged down in some very menial, basic and repetitive tasks. You don’t need your nurse spending time on data entry or filling out school forms.

Is it realistic for a practice to go completely paperless?

Yes, but not in the near future. You couldn’t do it yourself. Vendors and everyone else that you deal with would have to be paperless, too, and that’s not happening. Many of the nursing home and hospice operators I talk to say they’re not going electronic because they don’t have the money. I think some things will always come in on paper.