Cathy Thomas Hess, BSN, RN, CWOCN, is Vice President and Chief Clinical Officer, Net Health Systems, Inc.
Please address correspondence to: Cathy Thomas Hess, BSN, RN, CWOCN, via e-mail: firstname.lastname@example.org.
The burden of chronic wounds is high. Associated morbidity, decreased quality of life, and, in some cases, mortality are among the many reasons significant interest has been focused on the prevention and treatment of wounds.
To support patients with chronic wounds and manage recurring patient visits, hospitals seek to open outpatient wound care clinics. To manage volume and support outcomes, utilizing a comprehensive, interoperable specialty wound care electronic medical record (EMR) with smart workflow synchronization is the key.
“Numerous documentation elements are captured for specialty care, which are not always available in standard EMR solutions. Some specialty documentation forms can be template driven, but others require complex algorithms to reflect the steps that specialty clinicians take in their clinical encounters. The views, protocols, and order sets are another aspect requiring special design and consideration. It is critical that the specialty content and workflow be analyzed correctly in order to effectively achieve user adoption.”1 Regulations must be inherently mapped within the EMR. Specific wound care elements and medical necessity requirements are essential. Clinical and operational wound care triggers, predictive analytics, and coding and billing requirements are also necessary to drive documentation standards, enhance outcomes, and optimize reimbursement.
One key step to a successful specialty EMR implementation is conducting a workflow analysis. This analysis maps current processes and data flows, identifies gaps to best practice, and produces recommendations for improvement through collaboration with clinical team members. It is paramount to ensure the clinic’s workflow is implemented correctly and customization of the software is complete prior to utilizing the EMR. These steps will ensure a higher adoption rate of the EMR.
According to a recent online article titled, Specialty EMR Market Not Completely Tapped,2 the author states “an EMR designed for everyone, in every specialty, really has very little value.” The author discusses the advantages of using a customizable specialty EMR system over a generic system:
* “Specialty EMR takes less time to implement and adopt
* Customized with the library of required forms and templates, which helps the user to focus on quality of care rather than writing templates
* Generalized EMRs could take a month to work properly, and the user has a higher chance of making errors while preparing templates. Specialized EMRs leave little room or no room for errors and omissions
* A specialty EMR is designed according to the workflow of a particular practice
* A general EMR system comes loaded with all types of features and functionalities whether a user needs it or not, distracting the user’s attention and efficient workflow
* Specialty EMR helps to improve competence through the accuracy of medical decisions.”2
As you move forward with your specialty wound care EMR, define your checklist for documentation success, which may include the following:
√ scheduling module
√ patient and physician portals
√ role-based workflows
√ predictive analytics
√ secure e-mail exchanges
√ smart EMR to meet the needs of all practicing clinicians and physicians in your department, as well as patients, who may access their defined information
√ clinical decision and practice management tools to alert users to medication errors and adverse drug interactions and to track test results and patient follow-up
√ interfaces to pull data in and out of your system and clinical and operational compliance and audit mechanisms to ensure success
√ compliance with Meaningful Use and Accreditation and Certification Standards
√ audit trail to identify work performed through documentation
√ facility level of care
√ physician evaluation and management
√ quality indicators
√ product formularies and order sets
√ test results imported
√ regulatory compliance pathways
√ care coordination process
√ reporting for outcomes and benchmarking
√ revenue cycle management
It is prudent for clinicians to record assessment, documentation, and clinical and financial outcome data in a specialty wound care EMR. The data collected can be used to advance critical pathways, improve product formularies, validate contract fees with payers, and improve patient and physician satisfaction, which increases business opportunities.