When pediatric ophthalmologist Amy Hutchinson (ophthalmology pathology fellow ’92-93; res. ’93-96) volunteered to represent ophthalmology faculty on a small task force almost two years ago, she and others were charged with identifying an ophthalmology-specific electronic medical record (EMR) for the Emory Eye Center. Because of the proliferation of EMR technology on the market and the unique needs of a large eye center like Emory’s, the task required substantial time and effort.
The software had to interface with Emory Healthcare’s existing EMR platform and required additional functionality to include drawings, photography, visual acuity testing, prescription information for glasses or contact lenses, and other ophthalmology-specific records. The system also needed to track discrete data elements from each exam, as well as diagnosis and treatment plans. These elements were needed to begin building a database for health care analytics, centered on providing quality care, feedback for self-assessment, and risk-stratified data to benchmark outcomes.
When Emory Healthcare initially entered the world of electronic medical records in 2008, Emory ophthalmology staff modified existing EMR digital records by scanning and uploading handwritten notes, images, and other hard-copy documents at the end of each day, a tactic that was impractical and unsustainable over the long term.
Hastening the need for implementation of an ophthalmology-specific EMR was a new federal mandate, passed in 2009, requiring that physicians attest to “meaningful use” of EMRs by 2015 or face penalties and the imminent launch of ICD-10. “We could not fulfill those requirements in ophthalmology using the hybrid system,” Hutchinson says.
The team carefully evaluated ophthalmology products in the marketplace and eventually chose a product called Modernizing Medicine’s EMA (electronic medical assistant) Ophthalmology. The system is fast, mobile, and cloud-based and enables physicians to access records via multiple devices, from tablets to desktop computers. Patient information can be exchanged between EMA and the Emory-based system through Emory’s health information exchange (HIE), a system that serves to provide accurate data and a large capacity to mobilize electronic information in a secure and regulatory-compliant network. The system reduces need for paper and scanning, enables automatic delivery of patient information and records, and reduces the possibility of lost charts.
“This is a powerful system that will ultimately improve efficiency, communication and overall patient care."
The new system has important features, such as an “eye log” that graphs eye pressure and visual acuity data recorded in patient visits over time, thus eliminating the need for doctors to page back through each individual records to track specific data. The system is able to learn the preferences of each physician and adapt to them, automatically generate letters to referring physicians, include relevant patient education handouts, and assist with billing. The system also will help facilitate transition to a new coding system (ICD-10), whose use is currently set to become mandatory on October 1, 2015.