For some time, federal regulators and insurance companies have made the strong push for all physician groups—including plastic surgeons—to move toward digital practice management and electronic health record systems (EHR). Eventually, it will mean the difference between getting fully reimbursed or not.
Even without the mandate, there are great reasons to do so. For starters, the cost of paper management is significant. Plastic surgeons could spend an average of $2 to $3 annually to manage, retrieve and store a single patient chart. Depending on the size of the practice, the hidden costs may be in the high five figures. With this daunting background, the right EHR system shouldn’t be seen as a necessary evil, but instead an efficient productivity tool that will save a plastic surgery practice money over time.
Plastic Surgery Specific
One problem is that the majority of EHR programs are designed for family practice and internal medicine doctors. These offices bill by patient encounters where detailed encounter documentation is encouraged by the software to maximize reimbursement. This interferes with the workflow of plastic surgeons whose revenue is mainly procedure-based. Pre-op as well as follow up appointments are often not billed at all. Second, most of today’s EHR systems are server-based and require the medical group to purchase and maintain at least one server on their premise, thus causing the implementation costs to rise significantly. While the hardware expenses can be upwards of $10,000, the addition of appropriately trained IT and security personal to run the servers and the need for HIPAA compliant data storage and backup processes adds further to the costs, complexity and liability risks.
Thankfully, the tech industry is beginning to respond and enabling plastic surgeons to look at EHR platforms differently than before. The key is to seek out systems that were designed from the outset to meet the needs of this particular group of medical professionals. They include the following features and benefits:
Features and Benefits
Surgeon-specific EHR platforms that tie into existing office practices. Stick with software that is designed from the outset for plastic surgeons. The right EHR system should be specifically geared toward a plastic surgeon’s day by managing schedules, price quotes, lead tracking, fast charting, labs, procedural notes, education and billing. It should also give the office the ability to upload scanned documents and photos to a patient’s online chart in order to migrate and minimize paper records.
Surgeon-specific software that includes as many features as possible in a single package. Dealing with a single software vendor for patient documentation, practice management, appointment reminders, inventory management, ePrescribing, insurance billing and patient portal will insure the maximum interoperability of data and reduce the need for duplicate entry of computer information. This will save time by having a single point of contact for software issues. It will also reduce the chances of finger pointing by different vendors when some data integration is not working properly.
Surgeon-specific software that is cloud-based. It is only in the last five years that technology advances have allowed cloud-based programs to mimic the look and feel of in-office, server-client software. These systems eliminate the high up-front costs, complicated software installations, expensive servers, infrequent updates and regular maintenance fees associated with traditional offerings. They run from most Internet browsers and therefore can be accessed from multiple devices, be they Mac, PC, iOS or Android-based. Cloud software provides “always on,” secure, anywhere access to patient data that, if designed correctly, should be fully HIPAA-compliant. Cloud is typically much less expensive than traditional software because the vendor is only dealing with a single software copy on the web-server. Updates are easily implemented by the vendor and are immediately available to every client the next time they log in.
Surgeon-specific EHR platforms that improve communication with patients and staff. These systems should enable plastic surgeons and their staff to send and receive notifications and alerts, schedule and find appointments, track prospects through the patient life cycle and see summary data about the entire practice and procedures. Some also include automated appointment reminders to reduce patient no-shows, and many will enable staff to create mailing lists for patient birthdays and office events.
Reducing Liability
There’s an additional inherent advantage to EHR platforms that are cloud-based, and that is the reduction of liability exposure for the practice. With a server-based system, doctors risk fines for loss of patient data if office computers or thumb drives containing patient files are stolen. In December 2013 a private dermatology practice in Massachusetts settled a potential violation with the Department of Heath and Human services for such an occurrence to the tune of $150,000. HIPAA compliant, cloud-based EHR systems eliminate this issue since data is never stored locally. Patient files are secured and encrypted on the cloud server with geographically separated data backup performed automatically. This eliminates exposure of patient data due to offsite backups or stolen computers and provides for data recovery in the event of a local or regional disaster.
One concern raised about cloud software is how to access data during an unforeseen network failure. The industry has responded to this as well by developing high-level redundancy at the server-infrastructure level to guarantee 99.9 percent and greater uptime availability. For local office network failure, backup Wi-Fi hotspots are available by practically all cellular vendors that be activated only as needed and allow the office to continue to operate until the connection is restored.
The move toward specialty specific cloud-based EHR and practice management software platforms is real and will happen. It’s no longer a question of if, but when. Thankfully, organizations such as the American Medical Association have recently called for an overhaul of EHR platforms in order to make usability a top priority. One key way to do that is by offering systems that cater to specific medical practices. For plastic surgeons, the shift can’t come soon enough.
Robert Pollack, M.D., is co-founder and CMO of SupraMed and a board-certified plastic surgeon in private practice in San Diego. He can be reached at rpollack@supramed.com.
