Eyeworld

OPHTHALMOLOGY BUSINESS 88 February 2016 as well as ongoing assistance. A combination of 24/7 live support, online training videos and onsite support services not only ensure a successful implementation but also set the foundation for ongoing ICD- 10 success. We began implementing the IntelleChart EHR in April 2014, beginning with new patients. With- in 4 weeks, all patients had been transitioned onto the system using intuitive features and responsive support—including consultative guidance. Then, a few months be- fore the October 2015 ICD-10 con- version date, we saw the first ICD-10 codes appear. Based on past experience, staff did not completely trust the EHR to get the coding right. Consequently, we performed occasional, random spot checks of the top-billed oph- thalmology codes, which proved the system to be accurate. Due to proactive planning, support, and upgrades in advance of the deadline, the ICD-10 transition was smooth and painless. Best of all, the prac- tice's cash flow hasn't changed now that the new code set is in effect. Word to the wise An ophthalmology practice is a com- plex business to run. As hard as it is to start over, investing in an EHR that lets the practice work better, faster and code more accurately can save a lot of time, trouble, and money in the long run. That's why it makes sense to evaluate the ability of specialty-specific tools to help reduce denials, increase claims reim- bursement, and improve cash flow. Even consider hiring a coder who can help ensure well-documented and correctly coded care. The pressure to meet regulatory mandates and improve the quality and cost of care is only increasing. Our advice? Forget about sunk costs; look instead to the future. EW by Gary Hirshfield, MD, FACS potentially resulting in inaccurate coding and therefore delayed billing and reimbursement denials—the new EHR can auto-generate codes, saving staff from having to learn new ones. It also highlights areas where documentation may need additional information to ensure compliance. Adaptive templates are specif- ically designed to meet the docu- mentation demands of ophthalmol- ogists, which helps ensure ICD-10 code compliance. Leveraging a unique set of defaults for each pa- tient based on his or her history and problem list, the templates provide only those choices relevant to the particular patient condition. Placing the most pertinent findings near the top, it shortens the pick and reduces the time to document with a high degree of specificity. The technology also flags potential problems with findings from a documented visit and notifies the doctor if a condition conflicts with the patient problem list. As a result, it helps eliminate mismatched findings, decreasing the risk of audits and improving overall care. Support leads to show time in no time The key to any successful technolo- gy implementation lies in training that continued investment was warranted given the resources we had already spent. Then came ICD-10. Faced with the transition to ICD-10, a poor vendor support track record and the reality that the current EHR was ill equipped for the new code set, the practice decided it was time to change. We desired an EHR designed specifically for ophthal- mology that was capable of keeping pace with the changing regulatory environment and enabling a smooth transition to ICD-10. It was time to embrace a change or risk losing significant sums of money and, possibly, the practice. We needed a complete, cloud-based solution, one that obviated any need for backup or worry over server crashes or hard- ware upgrades, with both software and support to make the transi- tion as seamless as possible. After reviewing a handful of vendors, we selected the IntelleChart solution (Nextech, Tampa, Fla.) based on progressive ophthalmology-specif- ic features that facilitate accurate coding while increasing practice efficiency. Unlike the previous EHR that relied on general equivalence map- pings (GEMs) to crosswalk between the old and new coding systems— O phthalmologists are trained to provide the full spectrum of eyecare, from prescribing glasses to precision eye surgery. Yet while they may be experts at treating patients, very few have business degrees or specialized prac- tice management skills. Poor real estate decisions and bad hires, for example, are common mistakes that constitute part of the typical learn- ing curve. However, many doctors make serious financial mistakes that can devastate their businesses, such as choosing the wrong electronic health record (EHR) and then stick- ing with it because of sunk costs. In economics, a "sunk cost" is any past cost that's already been paid and cannot be recovered. Since the money already has been spent, the idea is that it can't (and shouldn't) factor into future busi- ness decisions. After investing 5 years and tens of thousands of dollars in an EHR, Hirshfield Eye Associates was like many practices that have an ex- tremely difficult time accepting that it is time to switch to a new system. New tools for new payment programs We were operating under the fallacy of sunk costs—believing Don't let sunk costs torpedo your practice's future Dr. Hirshfield is founder of Hirshfield Eye Associates, New York. He can be contacted at garymdeye@ gmail.com. About the author

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