Customized EMR Tools Improve Patient Care

By Rishi P. Singh, MD

In ophthalmology, patients often see multiple specialists over many years. Our field also utilizes tests and treatments at a high frequency, often in a single visit. All of these factors contribute to an enormous amount of data that we must review to make informed clinical decisions. In short, data overload makes caring for medically complex patients particularly difficult in our field. In addition, billing staff do not often collaborate with patient care staff and thus do not always know what services and procedures the patient received.

At Cole Eye Institute, our customized tools within the electronic medical record (EMR) help coordinate patient care, track clinical outcomes, inform physicians on best practices, and prevent erroneous medical billing.

Features include:

1. Customized snapshots provide a detailed history of the patient’s visual acuity, eye pressure results, summarized procedures and medication lists. This tabular summary helps guide treatment decisions and shows patients their progression over time. A comment area reminds physicians of patient preferences like name.
2. Clinical decision support tools. For example, on entering the chart, the EMR can alert the physician to a medication on the patient’s list that might cause eye toxicity and suggest the appropriate tests to order for screening.
3. Portability. It’s common for a patient to see an optometrist, then a general ophthalmologist, and finally a specialist depending on the complexity of the medical issue. In the past, office visit notes had to be faxed along with images. Now, the chart and images travel alongside the patient, reducing repeat testing and improving continuity of care. Any provider who participates in Cleveland Clinic’s MyPractice online referral and patient monitoring system can review all charts and images from any connected location.
4. Improved billing processes. When a physician orders a test or procedure, the EMR sends an alert if the diagnosis code is not correct for the order. Only when the physician signs off on the order or procedure is the charge forwarded to the billing office.

Our customized EMR benefits both clinicians and patients. Future versions will offer additional clinical decision support tools that will further increase the quality of care provided to our patients.

Figure. Our physicians use an advanced ophthalmic imaging platform which collates information on patient anatomic changes from multiple visits on one easy-to-read screen. This allows quick observation of longitudinal changes and faster decision-making regarding treatment.

Dr. Singh is Medical Director, Clinical Systems Office, and staff in the Cole Eye Institute