You’ve read the articles, you’ve talked to a half-dozen EMR vendors, and now you’re ready to move your practice into the future. Everyone is doing it, and so should you. It’s time for your practice to go completely paperless.
But before you throw out all of your patient charts, maybe you should stop and ask yourself: Is it possible to get rid of all your practice’s paper? Is paperless really even that great?
“What’s the matter with paper?” asks Physicians Practice’s own Pamela L. Moore, PhD, CPC. “If you could run an office efficiently and lucratively using clamshells or chocolate bars, I don’t care.”
Don’t start asking patients to pay with candy just yet. But you can use this opportunity to evaluate your practice’s goals: Where do you want your practice to go, and how is paper holding you back?
Needle in a haystack
The real problem with paper is that it takes up a lot of room and is never where you want it when you need it. It’s hardly surprising that you can’t find the one file you need in a room that contains more than 1,000 square feet of patient charts. All it takes is one busy employee to misfile a chart, and then, poof, it’s as if that file has ceased to exist.
Since EMR systems are focused primarily on getting the medical chart into an electronic format, most practices think going paperless will solve all of their problems.
There’s no doubt that the ease of accessing thousands of charts at the touch of a button can help. An EMR puts an end not only to searching for misfiled charts, but also to marching from front desk to file room, walking back again to the photocopy machine, and shuffling files between physician offices and the front desk — not to mention the enormous amount of time spent refiling charts that are pulled throughout the day.
“The biggest waste of human resources that people have in their offices is filing,” says John Bonini, a practice manager who has overseen EMR conversions at two orthopedic practices. At Nassau Orthopedic Surgeons on Long Island, Bonini employed 14 front-desk staffers before an EMR conversion in 2000. Six months later, that number was down to nine — a 36 percent reduction. Bonini realized that the practice had been paying the equivalent of three full-time employees just to look for and move around paper charts.
“Nobody’s job is called ‘Go look for things all day,’” says Bonini. “But if you add up the amount of people who you have doing that all day long in a paper system, that’s about what you’ve got.”
An EMR can free your employees from those kinds of demands, but what about all the other pieces of paper in your practice? What about the paper that never gets filed in a chart — or the paper that hasn’t been filed yet?
Most experts recommend focusing on practice work flow instead of just throwing out paper. Paper isn’t necessarily the enemy. Waste is the enemy. “Your objective is not to get rid of paper, but to make your work flow at your practice more efficient so that you can get a return on that technology investment,” says Moore.
Viewed from that angle, digitizing patient charts is just one component of better efficiency. Moore recommends that practices map out their entire work flow — literally. She’s helped practices do just that on index cards. Start with patient check-in: Where does the patient go, and which employees help that patient? What are the next steps?
“Understand what needs to happen, then you can look at how technology can help you make that better,” says Moore.
Uncharted territory
