Eyeworld

I WHAT OPHTHALMOLOGISTS SHOULD BE DOING TODAY OCTOBER 2019 | EYEWORLD | 51 "They can focus on the patient without having to stop the exam to document as they go, boosting productivity," Ms. Jacobs said. "This translates into shorter time for the patient in the exam room, which makes the appoint- ment more efficient and leads to the ability to book more appointments, which means in- creased revenue." One tip Ms. Jacobs offered is to have scribes pull up the patient's EHR before the doctor enters the room so there is no time wast- ed logging in and loading electronic documents for the exam to begin. She also said that pairing one scribe with one doctor seems to be the most efficient as the pair can establish a rhythm together. "In our practice, our technicians are also scribes. They conduct all portions of the visit that a tech normally would do including the patient history. Then when the physician comes into the room, the tech puts on their scribe hat," Ms. Jacobs said. She also noted that scribes should never make diagnoses or treatment suggestions be- yond what the physician directs. It's the phy- sician's job to review documentation that was scribed in, add any pertinent information, order and review testing, and sign off on the record. Mr. Koch said his practice uses scribes because many high-volume doctors prefer not to type during exams. He added, however, that he knows a lot of doctors who successfully see a standard volume of patients while performing their own data entry. CPT codes require a specific diagnosis or di- agnoses, in addition to those in the assessment and plan, in order to be reimbursed by payers," she said. How to document The sources EyeWorld interviewed for this article were split on the utility of scribes for enhancing EHR management. Dr. Davis said he sees 70–80 patients daily and records interactions without the help of a scribe. "My intimate relationship with the com- puter and the patient enhances my interactions with both," he said. "I have all the needed information at my fingertips and sit so I swivel easily between the computer and the patient. I can show testing results to patients, find information that I need to make decisions, send out scripts, make eyeglass prescriptions avail- able, send out reports, do the billing, and close the chart all while interacting with the patient. Occasionally, I will ask the circulating tech to complete some tasks, such as renewing multiple meds or sending a report to a physician not in the database, but 99% of the charts are finished by me alone." From a cost-saving standpoint, Dr. Davis said that scribes should be used judiciously, not as a panacea. He also thinks younger ophthal- mologists, especially new hires, should learn a scribe-less system. On the flip side, Carrie Jacobs, COE, said using a scribe can maximize efficiency and allow the physician to focus solely on the patient. Percentage of office-based physicians with electronic health record system, 2004–2017 Source: Percentage of office-based physicians using any electronic health record (EHR)/electronic medical record (EMR) system and physicians that have a certified EHR/EMR system, by U.S. state: National Electronic Health Records Survey, 2017 About the sources Richard Davis, MD Ophthalmic Consultants of Long Island Huntington, New York Carrie Jacobs, COE Chu Vision Institute Bloomington, Minnesota William Koch, COA Administrative director Texas Retina Associates Dallas Candy Simerson, FASOA iCandy Consulting Tucson, Arizona continued on page 52

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