Ophthalmology Business is focused on business topics relevant to the entrepreneurial ophthalmologist. It offers editorial, opinion, and practical tips for physicians running an ophthalmic practice. It is a companion publication of EyeWorld.
Issue link: http://digital.ophthalmologybusiness.org/i/138484
continued from page 15 surveys and less patients seen. With scribe staffing services these days, most often the use of a scribe is a net gain in patient volume and profit. 2 If a scribe is going to be in the lane, try to place the scribe at the end of the counter nearer the door. This allows them to enter slightly after the doctor and get to their spot without crossing the paths of the doctor and patient. Having the computer screen on an arm that extends out is still a good idea because there will be times the doctor wants to see the record or show images to the patient in the chair, and you want to be able to do this without leaving the patient's side or the patient leaving the chair. See the diagrams of the exam lane. Some practices have two computer screens, one for the scribe and one for the doctor. This second screen could be mounted on the ophthalmic stand. 3. If you are not going to use a scribe, consider a moveable cart that has the computer on it or the screen on a long arm mounted above the counter. Some practices incorporate the EHR screen and the computer acuity so images can be shown on the screen. The objective is to get the screen in a location that allows you to face the patient and family during the data entry portion of the exam. If the staff that works the patient up is different than the staff scribing (or no scribe) then there needs to be some system to get preexam work-up information to the doctor and follow-up work instructions to the staff. 16 Solutions Solutions 1. We feel the best solution is to have multiple staff working with you that work up and scribe/assist in the lane on the patient they worked up. That staff stays behind to perform any follow-up work. This helps with the continuity of the visit by having the support staff the same. In this case the tech/scribe would present the patient to you at the door before entering so you know who, why, and what. And when done you do not have to find someone to give instructions to. 2. If the scribe is different than the work-up staff, there will need to be a computer station that the doctor can go to review the chart and preexam work before entering the lane. This station needs to be centrally located to all the lanes in that doctor's pod, or you can use portable tablets. Due to privacy issues, having these on the wall in the hall is not the best solution. Some practices not using portable tablets will print a summary sheet on the last visit, test results, etc., and place it in the chart rack outside of the lane. 1. Space for a printer can be incorporated into lower cabinetry most often to allow papers to be printed there in the exam lane. This keeps the printer close to the scribe and the counter clear. 2. A printer can also be placed at an alcove or tech station if this is central to all lanes in the pod. If it's a paper script, the doctor will need to walk to this location to sign the scripts so it should not be remote from the lanes. 3. If it is a glasses script, we often recommend you to print in the optical dispensary, if you have one, so the patient goes there to get it. This has proven to increase sales. Question Will there be a need to print information for the patient to take home? If so, how will this be handled? • Often times the doctor wants to give patient education material, a copy of the visit summary, paper script, etc., to the patient. Where will the printer go and who will give the printed material to the patient? Ophthalmology Business • July 2013 Conclusion EHR systems are great storage tools that don't often improve the patient/ doctor interaction. Do not let your EHR turn you into a data entry clerk, reduce patient volume, or reduce the time you spend with patients. As you evaluate and implement your EHR, look at how it will be used during the exam process, not just how the business of coding, storage, and meaningful use is addressed. There are systems out there that handle the patient visit better than others and accomplish all the other items as well. OB Larry R. Brooks is an architect, president of Practice Flow Solutions, Norcross, Ga., and widely known as an expert in improving the flow patterns of medical practices. He can be contacted at brooks@ PracticeFlowSolutions.com.