The Incremental Approach to a Paperless Practice

As we study the reluctance of some practices to automate the clinical side, we see that cost issues are not the only reason for slow adoption. The success or failure of an EMR in many cases depends upon the behavioral and workflow issues within a practice and how those issues are addressed. It is critical that the EMR solution allows for flexible workflow and document options to sustain a successful implementation. A key component to the implementation must be based around a solution that is modular and flexible to fit the variety of workflows that exist prior to the introduction of technology.

The Incremental EMR

The incremental EMR is easiest to understand as a staircase, each step represents a component to EMR automation. Most practices have practice management systems for scheduling and billing purposes, this system creates a solid foundation of patient demographic data in which an electronic health record can be built.

To move beyond practice management and begin the process of automating the clinical side, it makes most sense to start with the patient chart because it serves as the focal point of patient care and the heart of the practice workflow. Bradford-Scott's PaperlessOffice is a medical document imaging system that provides a cost-effective way to automate the patient chart without requiring a paradigm shift for the way physicians practice medicine.

PaperlessOffice accesses patient data from the practice management system and serves as a single repository for all of the patient-related paper that flows around the office, whether it is generated from within the office (notes) or outside the office (lab results, referrals). Perhaps most importantly, because it is an image and not text, the electronic chart looks exactly like the paper chart the doctor currently uses. Automation is modular, allowing clinical and office staff to gradually build their system to a full-fledged EMR as they are ready.

Implementing Additional Modules

Once a practice has firmly established a paperless record, it is ready to integrate additional modules into the system. These modules include TouchScript (prescription writing) and TouchChart (progress notes, coding and charge capture, physician order entry), and can be added in any order as the practice sees fit. There is no predetermined order for installing additional modules, as individual modules don't depend on each other to work. This flexibility is the beauty of the incremental approach.

Once all the modules are installed, your organization will benefit from a complete EMR system. Adding components incrementally, as the practice is ready, allows a much smaller up-front capital expense along with a chance to evaluate results throughout the process. By controlling the implementation of the system into your practice, you allow a much better chance at overall success, both financially and clinically.