Providing your patients with useful clinical summaries to meet meaningful-use requirements might be trickier than you expect.
In addition to providing documentation of an office visit, clinical summaries provide an opportunity to truly connect with patients and get them engaged in their own care. In fact, doing this correctly can lead to better patient compliance and better outcomes. A good clinical summary gives your patients take-home instructions about what medications they need, any other clinical instructions you might have, and information about follow-up appointments and referrals.
The Stage 1 rules of meaningful use require that you provide this summary to more than half of your patients within three business days of the visit. The rules for Stage 2 require over half of your patients as well, but you have to provide the summary within one business day of the visit. If enough of your patients are using your portal, you can limit this requirement to those patients. This can be both a help and a hindrance.
A good clinical summary can also be time-consuming and potentially frustrating for you and your practice staff. Here are a few tips to make sure your clinical summaries are helpful for you as well as your patients.
• Make it teamwork. If everyone in your office, from front desk to nursing staff, documents the information they are responsible for (front desk: demographics; nursing staff: vital signs; etc.), you are left to input only the most pertinent clinical information.
• If your EHR software has voice recognition software, use it. Documenting verbally rather than typing can be a big timesaver.
• Be prepared to print or send the summary quickly. You will probably need to give a printed copy to most patients before they leave the office. However, with patients who use your patient portal, you can provide the information electronically, giving you a little more time to fulfill the time requirement.
• Set guidelines for patient portal communications. . No matter how carefully you've explained things during the patient visit, the information on the clinical summary can sometimes be confusing or even surprising for your patients. Lab results can be especially distressing. Some patients may use the portal to send you a quick message to clarify something. Others may bombard you with messages.
"I'm not going to deceive you; it can be a lot of work," said Scott MacDonald, EHR associate medical director at University of California, Davis. MacDonald suggests making your expectations clear from the outset. A statement on your portal site, tactfully issuing some guidelines about how many messages you will accept, how long they can be, and how quickly you will respond, can save you headaches, and in the long run establish a much stronger relationship with your patients.
"There are no manners or social norms for this yet; you have to set boundaries about your time," he added.
Clinical summaries can open the dialog between patients and their physicians, and this can be a very good thing for everyone, as long as you do it carefully.