You expect a lot from your staff, and the same should hold true for your electronic medical record (EMR). A 2018 report published in AAP Pediatric News Magazine found the overall EMR software industry has not emphasized functions that are vital for pediatric medicine. That’s why a pediatric-specific solution like Office Practicum’s stands out among its EMR competitors.
Susan Kressly, MD, FAAP, is the medical director at Office Practicum (OP) and has been in pediatric private practice since 1989. She explains her recommendations for the expectations that a pediatric practice should have for an EMR, and how a pediatric-specific EMR improves patient safety and can increase revenue for an office through better patient services.
How does an EMR like OP’s compare to a living, breathing office manager or practice administrator?
Susan Kressly: When you hire office staff, they are energized, excited and always willing to listen and move beyond expectations, and are continually evolving and solving problems. If you have a good staff member, they’re reliable and they show up. Not only do they do their job, but they go above and beyond.
The same should be true of your EMR solution. OP’s cloud-based solution is reliable—available 24 hours a day, 7 days a week—and, unlike its human colleagues, it never calls in sick. In addition, the solution is constantly evolving as the pediatric healthcare environment and our clients’ needs change. We have over 200 pediatric-specific well and sick visit templates to help improve clinical outcomes and workflows. Plus we provide tools to manage and forecast your vaccine inventory (See next “expectation” for greater details). Put simply, we automate processes, like these, which are time-consuming and prone to human error.
What kind of vaccine management can OP provide?
Susan Kressly: Next to payroll, vaccines represent the highest expense for pediatric practices. If they’re managed well, vaccines are a good way to increase profits. If not, they can become a drag on practice profitability.
With OP’s vaccine management solution, you know how many doses of vaccines you have in your refrigerator and the cost of those doses should you need to replace them. In addition, the solution indicates the number of vaccines that can only be used by the Vaccines for Children (VFC) program. OP becomes your virtual vaccine inventory nurse. Your staff will no longer be responsible for the onerous task of counting vaccines to ensure that they are being used appropriately.
With OP’s VacLogic™, you can track each patient’s immunizations and forecast when vaccines are due. We can do this because the Advisory Committee on Immunization Practices (ACIP) guidelines for the age-appropriate vaccination are built into the OP engine, enabling you and your staff to see at any time when a patient is due to be vaccinated.
For example, if a certain state were experiencing a measles outbreak, a pediatrician in that area could easily identify all their patients who need the measles vaccine and schedule them for a shot. That’s good care and good practice, and if you manage it well, it can be a revenue-generator for the practice.
In addition, OP has an inventory forecasting tool. It can tell you how many people will need shots at different times throughout the year. This is great for an office to know how many vaccines to order so they don’t lose the opportunity immunize when patients are in the office because of inadequate supply. Having the right inventory and the ability to predict that intelligently is valuable.
The solution also provides patient safety information at the point of vaccination ordering to ensure patients get exactly what they need, when they need it.
How does OP help with care plans?
Susan Kressly: OP helps with care plans in a number of different ways. Let’s take caring for asthmatics and ensuring they are coming in for appropriate follow-up. You can try to catch these children when you see them in the office for a well or sick visit, or you can invest some time in understanding the care plan functionality in OP and create one that is unique for this population and works for your office. This way you can ensure that proper patient follow-up is taking place. With OP care plans, the work is done for you.
By using this functionality, you start to understand how to better provide population health management. Instead of serendipitously finding and closing gaps in care for patients who happen to be in front of you, you use the care-plan functionality to run reports and proactively reach out to patients and families using the integrated messaging provided in the OP patient portal. It’s not only relying on the product, but also having staff think about how you can use the solution to take care of your patients in a better way, which is what your staff is great at doing.
Your staff doesn’t just answer the question that’s in front of them. They think, what’s next? How can I be doing this in a better way? If you have the right tool in front of you, and you embrace it, you realize how you can partner with the solution to provide great care to the family.
How does OP help with provider follow-up?
Susan Kressly: Here’s one example from my practice. We wanted to improve our HPV prevention rates so we launched a quality improvement initiative to do so. When you implement a program like this, you assume that everyone in the practice is presenting the program in the same way, but since you’re not in the exam room with the providers to actually hear what they are saying to the families, you don’t know for sure.
If you had a great tool, you could track the patients each provider saw and determine where there was a missed opportunity to vaccinate. Furthermore, you could see if this is a one-time occurrence or a trend.
I actually found the latter to be the case in my practice. Using OP’s reporting functionality we were able to see that one of our provider’s quality scores were not improving at a rate commensurate with the other providers – she was lagging behind significantly. After a discussion with the pediatrician, we discovered that she was not making strong HPV vaccine recommendations because she has a more difficult time addressing conflict than some of the other providers. When parents pushed back on vaccinating their children, she didn’t feel comfortable forcing the issue because she didn’t know what to say in response. When we uncovered this, we provided her some coaching so she would feel more comfortable and confident dealing with parents who immediately dismissed the vaccination.
In the end, she was able to provide improved patient care and increased vaccination rates, a win-win for everyone.
How does OP help improve patient safety – a top concern set forth by the American Academy of Pediatrics Council on Quality Improvement and Patient Safety?
Susan Kressly: When you’re tired or overworked, you rely on your staff to catch you before you may a mistake. Similarly, if your EMR includes appropriate clinical decision support functionality, it can provide the same type of safety net. For example, if a physician wants to make a certain decision that is not within the schedule the tool monitors for patients, the EMR will confirm that this is truly the decision the physician wants to make.
Just like a good team member, a good EMR tool has your back.
How does the right EMR improve efficiency and revenue for a practice?
Susan Kressly: OP’s EMR can be used to fill gaps in your schedule. We were able to do that in September. We were much lighter in sick appointments than we had anticipated, so the staff took this opportunity to use the tool to determine ways to plug holes in the schedule. They did recalls on target populations who were due for wellness visits and chronic-care visits for things like asthma and ADHD.
Employing this approach translates to increased payments. First of all, by filling gaps in your schedule vs. just accepting them, you get paid. In addition, when you close care gaps for chronic diseases, those patients are less likely to end up in the emergency room and/or at the last minute utilize urgent care or other resources that should be captured in your office.
Office Practicum helps pediatric practices improve the service they provide their clients by using intelligent recommendations to improve patient care and safety. This ultimately can benefit practice revenue, as your team is freed up to provide better patient recommendations and follow-up.
“Pediatricians and staff members need to ask themselves if their current EMR is providing value to the practice by meeting the expectations the practice has for the solution. In other words, is the current solution a valuable member of the practice team?” Dr. Kressly says. “If it’s not, they should consider switching to an EMR solution that is.”