Electronic Health Records - Improving the Quality of Care in Dermatology

For patients, a visit to the dermatologist conjures up visions of long wait times and multiple forms to fill out. For staff, it means chasing paperwork, patients, and one another all day long. And for the physician, it's a constant race to keep up while running behind. 

Is there a solution that can create a positive patient visit for everyone involved? Absolutely. It's called an electronic health record (EHR).

By integrating the right EHR system into a busy dermatology practice, a physician can streamline the entire patient process from check-in to follow-up visits. It can improve every aspect of the workflow for staff, and increase the quality of each patient interaction. Ultimately, using an EHR system boosts the overall health of a dermatology practice for everyone involved - personally, professionally, and financially.

What is an Electronic Health Record (EHR)?

An electronic health care record is the digital version of a patient's paper medical files. It contains their entire medical history including everything from diagnoses and treatments to lab results and billing. Its secure digital format allows it to be shared with other healthcare providers and organizations, creating a more streamlined and efficient workflow in the diagnosis and treatment of patients.

The Benefits of using a Dermatologist Centric EHR system

The benefits of incorporating a dermatologist-centric EHR into a dermatology practice are numerous and may include:

1. Team-based functionality that allows pre-visit planning between the physician and staff. Every member of the staff can work simultaneously inside the patient’s medical file before, during, and after an appointment. This means less wait time for patients after check-in, and greater efficiency for the dermatologist and staff during the patient visit.
   
   
2. The ability to upload and attach photos to a patient’s record and use 3D anatomical mapping to denote areas of concern on the patient’s body. 3D anatomical mapping is faster to use during the physical exam than drawing on paper diagrams. And being able to attach photos to a patient chart is important for quality and safety processes.
   
   
3. More accurate medical coding provided by using ICD-10 codes that the software can autosuggest. This lets the dermatologist or staff member assign the correct codes to the billing process immediately instead of spending time researching the right ones.
   
   
4. Mobile accessible software used via iPad or smartphone which lets a physician or medical assistant edit a patient's medical records from their office or on the go.  Many practices utilize an iPad for documentation during a patient appointment.  
   
   

Features like these create the added benefits of faster and more detailed access to patient medical history, in-office dermatology-specific workflow efficiency, and increased patient engagement in the total care process. This team-based approach to care cuts down on wait times for patients, increases communication among office staff before, during, and after patient visits and allows the patient and physician more focused time together.

Key features of a good EHR for a dermatology practice

When considering an EHR for a dermatology practice there are several key features to keep top of mind. 

1. A dermatologic examination usually covers multiple lesions on different body parts. A good EHR should have the added functionality of a clinic note template and 3D anatomical maps of the body. This allows the clinician to quickly and easily identify these areas during the physical exam and creates accurate E/M services coding.
   
   
2. A good EHR should integrate and automate billing and scheduling. This gives the clinician the ability to complete the visit quickly by having access to all of the billing and demographic information during the patient’s visit.
   
   
3. Dermatology is a visual specialty and an EHR should offer the clinician the ability to integrate photos quickly into a patient’s chart.
   
   

Choosing the right EHR system for your dermatology practice

There are numerous EHR vendors offering electronic health records systems for any physician but also specifically to dermatologists. But choosing the right “dermatology” EHR software doesn’t have to feel overwhelming. 

Start by outlining the requirements and functionalities of your practice. Who will be using the software? What tasks will they need to be able to accomplish while using it? What additional features would be a great addition to your practice? 

Would a patient portal give your patients a better experience? Would the ability to send prescriptions to a pharmacy with a few taps on a screen or communicate with a network of laboratories would be useful to your staff? Make a list and apply it to the EHRs you review.

It’s also important to consider the type of platform that will host your system. EHRs are stored on either a cloud-based platform operated by a separate company or the files are locally-hosted on servers at your location. 

What’s the difference?

A cloud-based EHR system requires less upfront investment in hardware and software. There is also less cost associated with ongoing maintenance and management, which might be the right choice for practices that do not have a lot of staff. The downside to cloud-based hosting is that the organization in charge of the platform has greater control over it and the data stored on it than you do.  And even though the organization has control over the software, both you and the organization share responsibility for the security of the data.

A locally-hosted EHR system is set up on server computers at your location. A high-speed internet connection is required. You control the servers and are responsible for their maintenance, keeping the data secure, and backing up the data regularly. It requires more time and investment on the part of you and your staff, but you do not have to rely on an outside organization for security, performance, and maintenance.

When making the choice of how to host, store, and access EHRs it is best to choose the system that will integrate efficiently with the requirements of your current business setup.

Most commonly used EHR systems in Dermatology

The most commonly used EHR systems in dermatology are offered by NextTech, Modernizing Medicine, and EZDerm. NextTech and Modernizing Medicine provide EHRs as part of an integrated software suite of products designed for use in dermatology and additional specialties, such as Ophthalmology and Orthopedics. EZDerm is focused solely on dermatology and does not offer software products for other specialties.

Each company offers a lot of the same features that are important to a dermatology practice.

• Cloud-based EHR software system (no requirement for on-premise servers)
• Autosuggest ICD-10 coding which reduces time spent searching for proper billing codes
• Mobile accessible EHR software for use on iPads and smartphones
• Online ePrescription management for providers and patients
• Patient portals for online appointment setting, check-in, and access to key medical information
• Patient notifications and reminders via email and text messaging
• Complete patient medical history available for dermatologist and staff
• Automated billing process 
• Ability to upload and attach images to patient medical records
• 3D anatomical mapping via touch screen to visually indicate areas of patient concern
• Customer support via online portals for dermatologist and staff

While these companies do have many similarities when it comes to their EHRs for dermatology, some of them also offer software packages designed for additional specialties.

EZDerm

EZDerm offers an EHR software system created for use solely in dermatology. The program is mobile accessible and allows for image capture, sharing, and retrieval. Currently, it is used only on an iPad or other Mac-supported devices. 

The EZDerm EHR has the following key features:

• Simultaneous multi-user documentation
• Real-time documentation
• 3D anatomical mapping
• Patient notifications via email and Instant Messaging
• Automated coding and billing
• Client support via an online portal

The EZDerm software provides several features for dermatology practices like 3D Body Maps that allow physicians and staff to visually document areas of concern on more than 3,000 anatomical areas during a patient visit. 

There is also a progress note tool that lets users store their medical notes in a secure format. And the software allows doctors to track areas of patient concern with diagnostic imaging.

For patient engagement, the EHR software contains a pharmacy geolocation module that lets patients find pharmacies in a digital map. There is also an appointment reminder module which sends both email and SMS reminder notices to patients about their appointments and lets them reschedule as needed.

EZDerm has an entire suite of software products that are aimed at providing complete support to any dermatology practice. Their software is cloud-based and fully customizable so it can be adapted to the particular requirements of both physician and staff.

For pricing, you can request a quote on their website or call.

Modernizing Medicine

Modernizing Medicine offers a cloud-based EHR system that integrates with an entire healthcare IT suite of products for a variety of disciplines. Their system was actually designed by physicians for physicians so it has a more intuitive feel. And their mobile accessible EHR software is an iPad application that comes packed with a knowledge base of specialty-specific information created by practicing doctors. This physician-focused approach to their software allows Modernizing Medicine to offer a more robust array of solutions to practitioners. 

Modernizing Medicine is loaded with features:

• Inventory Management
• Detailed administrative, financial, and provider analytics
• Ability to upload and attach images to patient files
• Online patient portal and patient notifications
• Revenue cycle management
• Automated Billing and ICD-10 coding
• MIPS intelligence platform
• Support via phone and online client portal

Another feature of their EHR system is its built-in adaptive learning. This lets it memorize the user's preferences for a more personalized workflow. And its tap and touch functionality make it easier for physicians to quickly select the most commonly used diagnoses and prescriptions during a patient visit.

Patient engagement is enhanced with a portal that offers information before, during and after a visit as well as electronic patient reminders and a fully integrated digital prescription process.

For pricing, you can request a quote on their website or call directly.

Nextech

Nextech offers an EMR (EHR) and Practice Management solution in a single database to dermatologists, ophthalmologists, plastic surgeons, and physicians. It's a web-based system that includes an iPad app which gives dermatologists and their staff the flexibility to access patient records from any location. 

Nextech features include:

• Ability to upload and make notations on images
• Revenue cycle management
• Customizable templates
• Patient portal with automated reminders
• Online lab integration
• Automated billing
• Complete inventory management
• HIPPA compliant dictation
• Support via phone and online client portal

Because of its modular style, Nextech’s EMR can be adapted to the working needs of any dermatology practice. It's ready-to-go with customizable forms and specialty-specific content that let dermatologists create the workflow they prefer. And office visits are completed with greater efficiency with the ability to write and renew prescriptions, add notes with talk-to-text dictation, and review lab results all inside a patient's medical record.

For pricing, you can request a quote on their website or call directly.

Conclusion

Integrating EHR software into any dermatology practice offers numerous benefits to the practitioner, staff, and most of all, the patients. And by automating tasks such as check-ins, prescriptions, lab work, charting, and billing the office workflow becomes more efficient and fosters a greater sense of teamwork.

For the dermatologist, digital patient records that offer the convenience of uploading photos, voice dictation, and drawing on images during the patient visit means less time getting bogged down in paperwork and more time connecting with patients. 

Choosing the best EHR for your dermatology practice doesn't have to be daunting. It just takes some planning and organization. Get with your staff and discuss the type of system you prefer, cloud-based or locally-hosted. Then make a list of the different functions that will create real enhancements to your current workflow and give patients a more positive experience. Review the most common companies and the features they offer and narrow down your choices to a few that seem like a great fit. Then get busy shopping!

Resources & References

https://www.mdedge.com/dermatology/article/171710/electronic-medica...

https://www.healthit.gov/playbook/electronic-health-records/

https://www.healthit.gov/playbook/patient-engagement/

https://www.modmed.com/dermatology-ehr/

https://www.nextech.com/dermatology/emr-software

https://ezderm.com/ehr/