Eyeworld

EW NEWS & OPINION 18 December 2017 by Michelle Stephenson EyeWorld Contributing Writer Device focus about the patient's background and from diagnostic equipment out of the EHR and puts it in one place to guide the surgeon toward a reason- able choice for a particular patient. "For example, if the patient is getting cataract surgery and is considering a multifocal lens, there is a lot of information we should look at to make that decision, such as the angle kappa, regularity of the cornea, and the amount of astigmatism," Dr. Hovanesian said. "The system will show the available options for a patient that fall within good standards of practice. The sys- tem allows for the doctor to choose a particular lens power and commu- nicate that to the OR. Then, in one or two clicks in the operating room after surgery, an operative report is generated that goes back in the EHR system. This increases efficiency. It also improves the quality of our care by encouraging us to adhere to es- tablished standards of care and then documenting that we've adhered in that way." Ms. Simerson thinks the most important advances are the patient portals and their communication capabilities. "There are new messag- ing and communication capabilities. You can use EHR systems to edu- cate patients and for appointment reminders, rather than having separate systems to do these things," she said. As for Veracity and MDbackline, Dr. Hovanesian said most doctors are hesitant to spend additional money on IT after they've spent so much on EHR. However, he thinks that these systems pay for them- selves because of the benefits they provide. Dr. Hovanesian noted that MDbackline is already in clinical use and has proven to increase adoption of premium technologies. He thinks Veracity will do the same. EW Editors' note: Dr. Hovanesian has fi- nancial interests with MDbackline and Veracity. Ms. Simerson has no financial interests related to her comments. Contact information Hovanesian: johnhova@gmail.com Simerson: candy.simerson@gmail.com For patients who are experiencing unexpected outcomes, the system stratifies the urgency of the problem and notifies the staff to respond. "This is helpful in a number of ways. First, doctors are being forced to see more patients in less time, so we can be confident that our pa- tients are doing fine without sched- uling a follow-up visit, having a phone call, or taking further action," Dr. Hovanesian said. "We're improv- ing our online reputation because the system automatically directs happy patients to an online review site, so they can say positive things about doctors. Perhaps most impor- tantly, the information gained from the system is being used by practices to negotiate access to plans that they might not have been able to get into. My administrator can take the data out of MDbackline and go to health plans and say, 'Who else can give you these kinds of outcomes measures directly from patients? Because we can, we should not only be allowed to be on your plan, but at preferred rates.' We're seeing 1% or 2% better reimbursement from having this data available." Veracity Veracity (Temple, Texas) was de- veloped by ophthalmologists to help plan for patients preparing for cataract surgery. It takes information sure that they comply with all of the regulatory requirements that they haven't been able to focus on mak- ing the system better," she said. They discussed with EyeWorld two systems that are proving helpful in ophthalmology: MDbackline and Veracity. MDbackline MDbackline is an example of how an EHR works for doctors because it extends the conversation between the doctor and the patient by using automation. "It follows patients who are on glaucoma medications to make sure they're compliant and not having unexpected side effects," Dr. Hovanesian said. "It's the kind of conversation that every doctor ide- ally would have with every patient, but it doesn't happen because of the time required. We make sure that patients have critical information preoperatively, like how to take eye drops and what to expect during their procedure. Then the system au- tomatically follows up after patients have undergone surgery to make sure they are having the expected result." He noted that patients are often hesitant to share information with doctors and their staff because they're not sure what information is relevant. They are much more candid with an automated system. New EHR options are helping ophthalmologists become more efficient M any ophthalmologists have struggled with implementing elec- tronic health record (EHR) systems into their practices and have seen some disadvantages with the current systems. "Since we've implemented these technologies, they've taken more of our time, allowed us to see fewer pa- tients, and have actually decreased the accuracy of what is in the record. Most doctors don't see EHR as contributing to the quality of care of patients," said John Hovanesian, MD, Laguna Hills, California. "In many small practices that can afford to ignore the penalties, they've done better by not using EHR systems. Having said that, most doctors who use EHR systems acknowledge that it has avoided some issues. It's sim- plified the writing of prescriptions, and it's made the information more universally available in different locations. There are no more lost charts." Candace Simerson, iCandy Consulting LLC, Tucson, Arizona, agreed. "The EHR companies have been so focused on trying to make Update on EHR

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