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Mike Uretz is a nationally-recognized Dental software and Electronic Health Records (EHR) expert. Mike has helped hundreds of individual practices and multi-clinic groups properly evaluate and select software vendors and solutions, structure and negotiate pricing and contracts, provide implementation oversight and vendor management. Mike was a member of the Certification Commission for Health Information Technology EHR vendor certification workgroup, and has been a member of various federal and state working committees for EHR business practices and policy. Having been involved with the EHR Incentive program from day one, Mike has helped a number of states, to evaluate and select EHR vendors, structure contracts and agreements, and manage vendor issues. As co-chairman of the Best practices advisory committee for EHR Contracts, Mike has been instrumental in developing standards for structuring vendor contracts and pricing for use by state programs nationwide He is the founder and editorial director of DentalSoftwareAdvisor.com, a trusted and objective online resource on all matters related to dental software. He is also the point person for Advanstar’s coverage of dental EHRs and their evolving role in the dental industry and can be reached by e-mail at email@example.com.
EHRs can play a positive role in group practices in more ways than one.
While helping group practices and DSOs evaluate electronic records over the past few years, I have always made a point to find out the reasons why these large groups opted to integrate electronic records as part of their long-term IT strategies.
There are several reasons both financial and clinical, but one reason that I hear consistently from group practice CEOs and COOs is that with numerous providers and locations in the organization it is important to try to standardize on various parts of their operations; with none more important than clinical data. So, with that goal in mind, where does one start?
The first step would be to develop and utilize an internal clinical advisory committee. In this way, the EHR and its associated templates can be designed to standardize the way the clinical staff treats patients.
Whether it is standardized exams, patient education or the use of evidence-based treatment plans, having an agreed-to, consistent clinical strategy can be established and supported by the use of EHR technology within the group practice organization.
With a flexible EHR system in a large organization, even if certain providers wish to tweak their templates to match their particular way of providing care, at least it is possible for all the care between providers and clinics to have vital elements in common.
A sophisticated group practice will develop libraries of templates, protocols, and treatment plans that can be reused by each provider without reinventing the wheel each time they need to create a document or ensure they are adhering to standards and procedures, mandated by corporate, insurance companies or government agencies.
Another important reason to standardize on EHR within a group practice organization, especially in a multi-specialty environment, is that each provider that touches the patient (general dentist, periodontist, orthodontist, etc.) has the same clinical data and medical history to refer to.
From a CEO’s or COO’s standpoint a good EHR system can also hold their providers and clinical staff accountable for providing optimal patient care. Through detailed and standardized reports and analysis a group practice organization can know where their clinicians stand regarding patient care and whether they are following protocols.
In a large multiple location organization, patients needing additional care and recalls, can often get lost in the shuffle with a manual system. With an EHR system there can be more revenue generated as well as better patient care by automating clinical alerts, recalls and regularly scheduled hygiene appointments.
From a workflow standpoint in a group practice an EHR system that supports clinical workflow will greatly increase the efficiency of any organization. I’ve seen and worked with systems that not only tracked all the clinical tasks needing follow-up, but also reported on what tasks were overdue based on various deadlines. With the large number of clinical staff and associated workflows to take into account with a multi-clinic group practice, having automation of this can give an organization an edge
Finally, a group practice with multiple locations can have better cash flow by utilizing EHR. That’s because automated coding at the point of care can seamlessly flow through to the claims processing system reducing the need for manual intervention and potential mistakes.
Tips for evaluating group practice EHRs
Although there are some similarities from a clinical standpoint when evaluating EHR for a group practice or DSO compared to an individual practice, there are several specific concerns that are specific to a multi-clinic group practice.
One of the biggest differences is in the areas of technology and support. Having been involved with IT for over 30 years, I am always concerned when a multi-location group adopts EHR technology, because there are numerous technical items to evaluate that a smaller practice doesn’t usually need to address.
For example, the ability to aggregate, process, reconcile and report on data sourced from multiple locations puts a highly-increased level of complexity on the software that isn’t found in every EHR system. So, questions must be asked surrounding communications, interoperability and aggregation of data between multiple locations and the “expanded services” capabilities of the EHR software that you are evaluating.
As we discussed previously, another feature that would be essential when you’re talking about a group practice organization is the ability to produce standardized libraries of templates, protocols and treatment plans that can be used throughout the organization.
Finally, the scalability or ability to expand the database to anticipate and meet future needs is extremely important in a group practice or IT environment. Because of the sheer number of records that will be imported into the system over time, it is important to make sure that all the technology you are purchasing with your EHR is “scalable” or expandable.