The Dilemma of "EMR"

EMR assist real time communication with patients during their clinical visits through immediate access to patient information, allowing Doctors to interact with patients rather than searching for information from paper records. However, for some, aspects of EMRs pose a distraction during patient visits. 

Because physicians do not have to call a lab for any test result, they spend more quality time (with the patient) in a more context-rich way. Similarly, because staff can pose questions to the physicians via the EMR’s electronic instant messaging (IM) function, rather than opening the exam room door, doctor-patient communication during a visit can continue uninterrupted, at least physically.

Many of us believed that EMR’s help in assigning responsibility for a particular task to a staff member via SMS or E-mail increased the efficiency for communications that do not require face-to-face interactions with them, such as scheduling a follow-up visit. On the other hand, some believed that the convenience of communication in EMRs decreased the likelihood that real-time communication would occur when needed most, for example, during patient emergencies. One of the physicians we met explained us the importance of discussing with staff the types of urgent or sensitive issues that should be communicated orally, such as notifying a physician about a patient’s arrival at the emergency department. He also added that- “You have to use electronic communication when appropriate and voice when appropriate, and even paper when it’s appropriate”.

Overcoming EMR-related challenges to interpersonal communication will likely involve continued refinement of their design by vendors and also use by clinicians to decrease the possibility for distraction during the patient visits. Efforts around the implementation of EMR’s at various levels like any Hospital or a private clinic must incorporate training to them to improve interpersonal communication skills for them. The modification of clinical workflows to maximize interpersonal communication while using an EMR is also likely to be helpful.

Maximizing eye contact with patients with strategic placement of monitor and also engage patients in relevant parts of EMR screen, such as problem list or medications, will help Practitioners in patient education purposes and also accuracy of information gathered. At the same time patients feel safe and more comfortable knowing that information from other Doctors are available.

So until and unless the adoption of EMR’s will increase, we can't get the convincing answer about the importance of EMR in the process of communication in Healthcare.

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Revenue Cycle Management (RCM) in Healthcare

The term Revenue Cycle Management or RCM as it is abbreviated is a common term in medical practices. At initial contact with a patient the revenue cycle begins and closes once the charges are paid in full and a zero balance is shown on the accounting register. For example: A Physician might see a patient for some problem, correct the patient’s complaint, see them for follow up, and done. It may be that doctor may never see that patient again. So the RCM related with that patient opened at the time of consultation and ends once the visit is completed and is closed with a relatively short shelf life.

Like any other businesses, there are various costs associated with medical practices. Considering the relation between a doctor and a patient, medical practices comparatively have a difficult time maintaining the RCM or to manage balance in their medical practices. The cost associated with a medical practice can be seen as:

• Medical staff: Salaries, insurance benefits, sick leave.
• Rent for the clinic/Hospital space, other utilities
• Taxes
• General Supplies: Paper, Folders, Pens
• Storage space needed for storing past medical information in a traditional paper environment, etc.

So to maximize the profit like any other businesses, medical providers have to watch closely the expenses with their income, which is a big challenge for them. So gaining efficiencies with an EMR will be a good step, which ultimately helps in reducing the expenses with its own benefits in their respective medical practices. The benefits of EMR are told and written many times on various platforms, but still it is most important to mention the benefits in terms of TIME & MONEY saved, which is the ultimate goal of implementing EMR in any type of medical practices:

• Quick and easy access to any patient information as and when required
• Automation of work flow helps in reduction of staffs, which ultimately reduce your expenses.

These are the basic but two most important benefits of EMR, which can’t be achieved without it. The medical practices can be made more efficient and more profitable with the addition of an EMR to track and bring closure to the RCM. Implementing EMR and to get its benefits, it is very important to understand that even the patients and clinical staffs are a part of it.

The best way to involve clinical staffs is to sit together with them weekly and keep the line of communication straight, simple and strong, so that they will also be on the same course as you are. The communication may be related with better patient care, improving efficiency in the clinical work flow, individual tasks and the like. It is for sure that every individual will not work on the same wavelength, but the lines of communication need to be kept open and ongoing, so that they can also discuss their issues or concerns and help the whole process of implementing EMR more clear and fruitful. The entire team needs to work together to insure the successful deployment of EMR and achieve the goals associated with this.

Also the patients have become more educated (thanks to Internet), and in most of the cases they have the information about their problems prior to the visit to a doctor. So your EMR will be the right tool to make them understand that their information is safe & stable than they are on Paper. So educating your patients, who are the primary beneficiaries- can help themselves by helping you. If Patients realizes that the information of them is more stable and safe, there will be no conflict.

Medical practices looking to gain and maintain strong revenue cycle performance should understand that there is a need to train the individuals associated, whether they are their clinical staffs or patients to achieve their desired goal.