The Ultimate Guide on How and Why To Go From Paper Charts to Electronic Health Records

This is a sponsored post by RevolutionEHR, a supporter of NewGradOptometry & new graduate optometrists!😎

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If you are like me, your fourth-year rotations were all in different modes of practice, but all had some type of Electronic Health Records (EMR/EHR).

So you can imagine my frustration when I started working after school in a couple of different practices and had to regress to paper charts. After a few months of my hand cramping, countless pens running out of ink, and just plain getting tired of writing, I decided to convince my employer(s) to make the switch and go paperless!

Although it was a daunting task at first, I have now successfully transitioned two practices from paper charts to electronic health records.

For those of you who have yet to take the leap, just a few reminders of the benefits of going paperless:

  • Environmental Benefits: Paper has an environmental cost, and that happens to be the extensive use of our precious natural resources – trees, water, and energy. Also, reducing paper use reduces greenhouse gasses.
  • Improve Efficiency: Most patients see paperwork as unnecessary, complicated forms. Electronic forms can now make that job easier and more efficient. Businesses that have converted to electronic records have found that it takes less time to both find and process information.
  • Increase HIPAA Compliance: With electronic records, it is much easier to maintain privacy and security of patient health information. Just make sure you also have a good IT person that has ensured all the computers and the rest of the office meet the privacy requirements as well.
  • Attest for meaningful use: If you still are unclear about meaningful use, read all about it in this great article, Meaningful Use: The How and Why for New OD Grads.

So after you decide to go paperless, then what?

It is time to choose the right vendor.

I used a number of different software programs over the years as a student but when it comes time to pick one for your practice it is not an easy decision. I won’t go into the pros and cons of the various software, but I will tell you what was most important in making my decision.

For our practice, the goal was thorough documentation and staying on top of everything so we can provide the best patient care, increase efficiency, and keep improving.

We decided that RevolutionEHR was the best fit for our practice since as companies we share similar goals and their software is very user-friendly, cloud-based, and organized and efficient for all aspects of the practice.

After you select which electronic health records you would like to use, it is time to transition.

I’ve put together a guide with 10 easy steps to going paperless in your practice including examples and screenshots from RevolutionEHR. I will also share why enabling these features are advantageous over using paper charts.

1) Select an in office Project Manager for your electronic health records migration

For our office, this was me. The most important thing here is setting a target date and timeline for implementation and training.

My office only has four employees total so we gave ourselves 3-4 weeks for this process. I admit, this is a daunting task to take on but the support team at RevolutionEHR made everything such a breeze. Our trainer was also amazing and did a great job keeping the office on track, not to mention a wonderful resource no matter what the topic.

One of my favorite parts about learning to use RevolutionEHR is their training platform called the “Sandbox.”

It is essentially a practice area for all of the things we will discuss, and you can play around with different data in the sandbox before setting up the data on the live site.

2) System Administration for your electronic health records migration

In the General section, you can enter all the office information including hours, doctor info, location specifications, NPI numbers, etc.

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The next section here is Employee/Roles. This is where you can enter all the info for your Employees including – job title, access to different parts of the electronic health records and even hours that the patient can access RevolutionEHR.

Continue through all the dropdowns in these two areas. One thing I really like about RevolutionEHR’s employee area is the ability to allow certain members of the staff to only login during working hours!

This is very helpful for cloud-based programs, so employees are not logging in from their home computers.

The Data Configuration portion is a highly customizable area of the Administration section with many of the subcategories already preloaded with information. Once you start using RevolutionEHR you will likely head back to this section to edit and change some of the preconfigured information.

One great benefit of electronic health records over paper is the ability to manage employee access which allows for greater security and monitoring. With so many moving parts and pages involved in patient encounters, it can be very easy to leave a paper trail (in the literal sense) which creates privacy concerns and makes potential HIPAA violations a reality. 

3) Set up Physical Inventory and Service FeesScreen Shot 2016-06-22 at 8.17.59 AM

In the Inventory section of RevolutionEHR, the support team can easily guide you through setting up your physical inventory and services with some of their pre-loaded and importable information, or you can work through it on your own and enter prices and other important information for all of the products and procedures you offer in your office including:

  • Frames
  • Lenses
  • Contact Lenses
  • Contact Lens Solutions
  • Miscellaneous Products
  • Services and Fees for procedures

This is a major advantage of electronic health record over paper charts. Electronic health records make it incredibly easy to manage inventory in an electronic database instead of on paper. Changes can be made immediately and updated seamlessly and in real time throughout the day.

Using an electronic health records with these capabilities also easily enables you to run sales reports, and obtain specific detailed information on products and services in your practice quickly and accurately. I commonly run sales reports on a daily basis, but also on a monthly basis to compare revenue from not only prior months but prior months from the previous year. This provides great utility in examining data to make practice management decisions and track and analyze the financial health of your practice.

4) Set up the Schedule and Appointment Slots

The schedule and appointment slots can be booked and set up based on provider, appointment type, and duration time. You can add different colors and times for different types of appointments and different doctors.

RevolutionEHR does a great job at continuously providing webinars and training programs to help your office better utilize the system.

Another benefit of electronic health records over paper. What better way to track and manage a schedule rather than in real time. As a doctor, I cannot tell you how critical and advantageous it is to be able to track patient flow and keep yourself on time.

I routinely check the schedule during and between patient encounters, so I know if patients have canceled appointments, or if a patient has been added to the schedule with an ocular emergency. I also utilize live schedule updates to track when patients are checking in so I know how long they have been waiting. You simply cannot do this with paper charts and paper scheduling.

RevolutionEHR also has a mobile app so you can check your schedule when you’re out of the office.

5) Exam Templates for electronic health records

This is the area that took me awhile to perfect in our office. Every exam template is completely customizable to follow your flow for Comprehensive Exams, Intermediate Exams, Contact Lens Exams, Follow Ups, Office Visits, etc.

I was extremely thankful that RevolutionEHR allowed this area to be so customizable and permit for:

  • Organizing the encounter templates from start to finish
  • Choose strategic names for your templates that fit your practice
  • Moving tests to different screens/areas of the templates for your exam flow
  • Creating new screens/areas for the exam templates for your exam flow

This area can be edited under the Administration and Encounters/Interviews tab.

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Another major advantage of electronic health records over paper charts is the ability to change the type of exam template for each specific patient encounter. This is particularly important for anyone managing ocular disease or providing specialty services like vision therapy or specialty contact lenses. I’ve worked in an office with paper charts, and it can be challenging using the same template for every patient encounter.

I found myself having to write in additional testing when needed or attaching separate exam sheets and documents. This is not a very organized method and can create issues when needing to review findings and data from previous visits.

6) Communication Letters and Templates for electronic health records

Under the administration tab, you can edit Communication Templates for patient summaries and letters to other providers. Again, like the exam templates, this area is highly customizable to fit each providers’ style.  

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A few categories below you will see Vendors and Partners which includes a sub-section called External Providers – this is the section to add other Ophthalmologists, Optometrists, Primary Care Providers and other health care professionals you may be sending a letter to or corresponding with.

Another area where paper charts fall flat. Communicating with other healthcare professionals is critical (and in a way necessary now with meaningful use and other requirements) in current times of a team-oriented approach to patient care. Keeping a patient’s primary care physician informed of diabetic eye exam results, or sending referrals to other eyecare providers for surgical intervention or treatment and management of disease is extremely difficult to do with paper records.

Referrals and communication are made simple with electronic health record, particularly with preformed templates. Most EHRs can automatically generate a letter with pertinent exam findings based off of the type of patient encounter, which once again, will save you a lot of time.

Another great benefit of electronic health records over paper is the advent of patient portals. You can allow patients access to their information and communicate with them directly which can help form a stronger bond and relationship with them.

7) Device and Partner Integration for electronic health records

One of the most helpful things about using an electronic record is when it can integrate with your equipment and systems already in place.

RevolutionEHR’s long list of partners can be found here.

Some of the partners we integrated our RevolutionEHR with include: Optos, refractive equipment (lensometer, auto refractor/keratometer, automated phoropter), SolutionReach, e-prescribing, and TAB scheduler.

Having many of our systems integrated with RevolutionEHR is a HUGE timesaver!

See the screenshot below for the area in RevolutionEHR, under Administration, that you will be linking this information.

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Obviously paper charts cannot integrate with diagnostic equipment, let alone other electronic resources. Electronic health records can not only integrate with these entities, but also communicate information between them.

Being able to access special testing results in real time during patient encounters for review is a massive time saver in any busy practice. This also helps with prescribing medications, as writing and or refilling medications and sending them to any pharmacy only takes a few clicks. My patients love having their medications waiting for them at the pharmacy by the time they leave my chair!

8) Data Transfer for electronic health records

If you would like to transfer data from an old POS or electronic system (i.e., OfficeMate), you will need to schedule a data transfer with a member of RevolutionEHR’s development team. This process may take up to two days so the in office Project Manager should have a target date for the transfer.

The wonderful thing about the Data Transfer is how easy the support team makes this process. We had a wonderful and easy experience inputting some of our current data into RevolutionEHR.

Keep in mind: It is important to set up the key areas of your live site before completing a data transfer. This includes all items we went over in step one including:

  • hours
  • locations
  • providers
  • contracted insurance companies
  • and encounter templates

9) Team Training for electronic health records

As the project manager, you should assign different training videos to Staff and Doctors based on areas of the software they will be using most. Obviously, different roles and offices will vary.

For Example:

  • Opticians – New User Training Videos, Orders Training Videos, Accounting Training Videos
  • Receptionist- Patient Management Training Videos, Scheduling Training Videos, Accounting Training Videos
  • Office Managers – System Admin Training Videos, Accounting Training Videos, Claims Training Videos
  • Doctor – Patient Management Training Videos, Provider Focused Training Videos, Communications Templates Training Videos

Also, after you launch, you will be able to access these videos all year round and register for more webinars to continue learning about the different areas of the system to maximize your software. In fact, I learn new and awesome things about RevolutionEHR almost every day.

10) Go Time

After completing much of the above in your office, you will be ready to go live and use your electronic health records in your practice.

While it depends on your practice’s specialty, chances are days aren’t too slow-paced around the office. Proper implementation of an EHR does take time and patience, but taking your time and going through the steps properly in the beginning will save you a lot of headaches later on.

About Kelly Keane

Kelly Keane
Kelly Keane is a 2013 graduate of New England College of Optometry. She is currently managing two practices in San Diego County, one an independent private practice and the second a sublease inside of LensCrafters. In addition, she works as an associate optometrist within the Sharp Healthcare System in a hospital based OD/OMD setting. In 2013, The American Optometric Association's Student New Grad Committee recognized Dr. Keane for her Outstanding Leadership in Optometry. She hopes to share some of her experience with other graduates through NewGradOptometry.com

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