Gut Check | Monday, May 15, 2017

EMR and the Next Generation in GI

Sara Johnson and Kelly Osborne, MSN RN CGRN

Both technology and healthcare are ever-changing fields in their respective ways. Where technology and healthcare merge creates even more room for a rapidly expanding industry. Electronic medical records (EMRs), a way to maintain all patient medical records in an online, shareable database, is one way we are starting to see this merge happen.

The Bottom Line caught up with Sara Johnson and Kelly Osborne, MSN RN CGRN of Duke University School of Medicine, to find out more about EMRs, how and when this will be implemented and what this means for both the technology and healthcare industries.

How will EMRs streamline patient care across healthcare?

Sara Johnson & Kelly Osborne: EMRs decrease the number of computer applications that staff and managers have to use, learn and manage. EMRs allow different practices to coordinate care across networks and share patient information. The patient’s medical history is stored and easily accessible by those within a system or have access to the EMR, which prevents patients and practice administrators having to chase down records/notes/lab results/etc.

What hinders the process of sharing information (e.g., paperwork, faxing, missing contact info, etc.)?

SJ & KO: Although many healthcare systems utilize a similar EMR those who use alternative EMRs or paper medical records require a release of medical records to be completed by patients. The timeframe for sending, receiving and tracking requests is time-consuming. Additionally, if patients arrive for provider appointments without previous records, the patients’ time with the provider is used to recap information that could have been reviewed prior to the patient’s arrival.

IT issues can hinder the receipt of records, written records are difficult to read and errors in demographic information leads to wasted time tracking patients down for contact information.

How will healthcare providers get permission from patients to “opt-in” to allow multiple medical professionals or facilities access to their information?

SJ & KO: Ideally, if the records are in the same EMR, then the permission would be automatically granted. There are cloud-based applications that allow access to patients EHRs. Permission will be granted based on the fact that the patient has an appointment with the provider. [Powershare]

Why are no-show rates so high for procedures? How will electronic reminders help patients manage their schedule time more efficiently? How will this help facilities and practitioners?

SJ &KO: There are several factors that increase procedure no-show rates including:

• Both the patient and an adult driver over the age of 18 need to be available.
• The patient may have insurance that has high deductibles, large co-pays and facility fees due at the time of service.
• The preparation can be challenging and requires advance planning so oftentimes patients decide they don’t want to do the prep.
• Appointments are scheduled in advance and patients forget.

EMRs could use secure messaging to easily and consistently communicate procedure appointment information with patients. EMRs could use phone apps to provide push notifications to patients to remind the patient about their procedure and ensure patients follow-through with their prep instructions. Anything we can do to decrease last-minute cancellations and no-shows would increase procedure volumes, increase revenue, increase access and provide better patient care.

How do you see these types of technology advancing further in the future?

SJ & KO: Cloud-based EMR applications will continue to grow to increase provider and patient access to medical records and radiology imaging. Real-time updates and automated workflows will decrease staff time in manually managing these process. [Routing patient reports, pathology, entering recall reports and updating the patient health maintenance status].

What will these technological advances mean in terms of the job market? Will this create or eliminate jobs? What will this look like?

SJ & KO: It would be natural to say that these technological advances would harm the job market and eliminate jobs since so many processes can be automated. While there is some truth to that, the healthcare industry continues to be extremely complex. With an aging population and a limited number of healthcare providers, we need to be smarter about how we do everything.

Work that is shifted to automated processes could be replaced by other, more strategic work. The job market within the industry will shift — lower level clerical positions may be replaced with IT positions, for example. But, at the end of the day, healthcare is a personal business. People want to work with other people — not just computers — so it’s also possible that the impact to the job market might be less than anticipated.