Some orthopaedic surgeons are wary of the potential challenges of transitioning to digital systems.


Published 3/1/2007
Jennie McKee

Is it time for your practice to go digital?

That’s the question Michele M. Zembo, MD, MBA; Glenn Sumner, MBA, and Ira H. Kirschenbaum, MD, hoped to help audience members answer during the Practice Management Symposium for Practicing Orthopaedic Surgeons, held on the Tuesday before the 2007 Annual Meeting.

Their session, “Preparing your office for the digital world,” explored the benefits of implementing electronic medical records, digital imaging, and other technologies.

Dr. Zembo began her discussion about how orthopaedic surgeons can digitize their practices by acknowledging that some orthopaedic surgeons are wary of the potential challenges of transitioning to digital systems such as electronic medical records (EMRs), but pointed out that it may be difficult for practices to participate in pay-for-performance without the use of information technology (IT). Companies that provide their employees with copies of their electronic portable personal health records may someday discourage those employees from being treated by doctors who don’t use IT, she noted.

The benefits of EMRs
EMRs, according to Dr. Zembo, provide an integrated view of patient data, allowing the user to view such critical information as past progress notes, problem lists, past medications, and allergies. They also provide access to resources such as alerts, reminders, knowledge references, and databases for clinical decision support. In addition, EMRs allow for computerized physician order entry.

EMRs benefit patients with consumer features such as portals where patients can view test results and schedule visits as well as access educational materials; the EMR system may also generate patient-specific instructions. Other examples of the benefits of EMRs given by Dr. Zembo include potential productivity improvement because of fewer chart pulls, improved billing, improved coding of visits, increased formulary compliance, and more accurate prescriptions, leading to fewer pharmacy call backs.

Using EMRs can significantly improve the quality of care provided in a practice because the technology provides such benefits as point-of-care decision support, integration of evidence-based clinical guidelines, and easier preventive care, said Dr. Zembo. She also pointed to a potential improvement in job satisfaction for those who use EMRs and increased customer satisfaction among patients who are treated at a practice that uses the technology.

Another reason to use EMRs, said Dr. Zembo, is the potential financial value of the digital system to practices. She noted that EMRs save money by eliminating transcription and reducing dictation while also making it easier for the practice to submit accurate, timely claims. According to Dr. Zembo, the savings achieved in the U.S. healthcare system from using EMRs could reach $80 billion per year, assuming a 90 percent adoption rate.

It’s okay to start slowly
Possible ways to begin integrating EMRs into a practice gradually can include using “EMR-lite” applications, which give the user the ability to chart electronically but usually have less robust features than a full EMR system. Using an electronic prescribing system or employing a handheld electronic billing device is another way to begin the switch to a digital office.

Physician ownership and buy-in are critical to implementing EMRs successfully, as are identifying a physician champion and practice administrator champion to help the practice make the transition. The selection committee for the EMR system should include different types of practice employees, including nurses, receptionists, and those who are skeptical of making the change to EMRs.

Consider finding out what kind of EMR systems similar practices to yours are using, advised Dr. Zembo, ask vendors for crucial information, such as the kind of maintenance and training support that are provided, before making a decision.

The AAOS Practice Management Committee has developed an EMR primer that includes information to help practices make decisions about EMRs. Copies of the primer can be downloaded for free from the AAOS online Practice Management Center. For a sampling of the information in the primer, see the accompanying “Choosing the right EMR system for you.”

Digital imaging

Following Dr. Zembo’s examination of EMRs, fellow presenter Mr. Sumner discussed digital imaging, which he defined as “the process for acquiring, processing, managing and sorting image data.” According to Mr. Sumner, digital imaging can be beneficial to orthopaedic surgeons because it “digitizes and more accurately presents critical diagnostic information.” Although digital imaging is expensive to implement, its benefits may be significant, including the ability to easily move images between hospitals and practices.

Finally, Dr. Kirschenbaum discussed how practices can use technology by exploring how orthopaedists can use the Internet to attract new patients.