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Evaluate your practice requirements

Blueprint for implementation
  1. Evaluate current & future function requirements

  2. Evaluate current & future workflow processes

  3. Select EHR & equipment

  4. Implementation and training

  5. Deployment

  6. Post deployment

Patient workflow begins at your web site and is the most vital port of entry into your practice. The importance of your web site cannot be overstated both in terms of attracting patients and office workflow.  Make sure you have enough information on your web site for a patient to make an informed decision to come to your practice without calling your office.  This reduces your front office workload significantly.

My practice web site gives me an unfair business advantage.  I'm amazed at how few practices get this concept.  Check out

Evaluate functional requirements

Practice Management
  1. Patient surveys

  2. Online reviews

    1. post to social media​

    2. post to web site

  3. Preference based communications 

    1. text, email, phone, mobile​

  4. Frame inventory online

  5. Recall

    1. eRecall​

    2. recall list print

  1. Online scheduling

    1. eSchedule vs request​

    2. auto write to scheduler vs

    3. manual write to scheduler

    4. demographics

    5. insurance information 

    6. appt list print

  2. Reminders

    1. appointment​

    2. recall

  3. Scheduling 

    1. time increments​

    2. templates

    3. drag & drop

    4. cut & paste

    5. next appt

    6. resource based

    7. day, week, mo views

    8. multi-location view

    9. appt type colors/icons

  4. Notifications

    1. contacts order ready​

    2. spectacle order ready

    3. online registration prior to appt

  5. Patient Portal

    1. Optical Rx's​

    2. Online payments

    3. Medical records

    4. Visit summary

    5. Medical history

      1. PFSH​

      2. ROS

      3. Lifestyle

    6. Secure messaging

    7. Secure text

    8. HIPPA support

  6. Online registration

    1. Demographics

    2. Insurance information

  7. Secure patient messaging

  8. Secure patient texting

  9. Into office messaging

  10. Marketing support

    1. patient referrals​

    2. provider referrals

    3. referral source

  11. Accounting-Patient

    1. general ledger​

    2. invoicing

      1. lab order posting​

      2. EHR exam posting

    3. eStatements

    4. online payments

    5. co-pay pre-payments

    6. balance transfers

      1. patient ~ patient​

      2. insurance ~ insurance

        1. primary ~ secondary​

      3. patient ~ insurance

  12. eClaims

    1. eEligibility/authorization​

    2. eVision claims

    3. eMedical claims

    4. ERA posting (electronic remittance)

    5. EOB posting

    6. RCM (revenue cycle management)

  13. eProduct catalogs

    1. spectacle lenses​

    2. contacts

    3. frames

    4. inventory

      1. bar code support​

      2. list of frames sold

      3. list of inventory (cost & retail)

      4. web site integration

  14. Reports

    1. day sheets​

    2. fee slip audits

    3. production reports

    4. marketing list support

      1. Rx range​

      2. ICD, CPT

      3. age

      4. demographics

  15. Third party integrations

    1. 4Patient Care​

    2. EyeCare Prime-Nexus (Web systems3)

    3. Weave

    4. Solution Reach

    5. The Edge/Pro

    6. Glimpse

    7. Others

  • Government compliant

    • MIPS-no extra clicks for MIPS​

    • secure messaging (provider & patient)

    • CCD communications (future mandate)

    • audit compliant

      • no exam cloning​

      • exam/invoice/claims-match

      • automated orders

      • automated I&R and op notes

  • Auto documentation of

    • interpretation & reports​

    • operative notes

    • assessment/Plan/Treatments

  • Communications

    • provider letters

      • eFax​

      • push document to text

    • patient visit summary

      • push to patient portal​

    • CCD (government compliant documents)

      • push to other EHRs​

      • push to patient portal

  • Product catalogs for all CL parameters

  • Refraction

    • digital refraction interface​

    • keratometry w/ copy forward

    • push Rx's to:

      • patient portal

      • lab orders (before, during, after exam finalized)

    • product catalog with all Rx configurations​

      • Hybrid-Synergeyes products

      • Soft contact lens database

        • private label support​

    • specialty custom CL all parameter support

      • soft, RGP & Scleral 

        • sphere w/ multifocal, toric, aspheric

        • multifocal w/ sphere, toric, aspheric

    • copy to functionality (bi-directional)

      • OD to OS​

      • multiple refractions - each w/ custom label

        • presenting​

        • lensometry

        • retinoscopy

        • cycloplegic

        • auto refraction

        • wavefront

        • photopic/mesopic/scotopic

        • final spectacle

        • alternate spectacle

        • trial contact lens

        • final contact lens

        • alternate contact lens

        • CL support

          • lens rotation​

          • lens fit

          • over refraction

        • Care and wearing schedule

    • refraction history view in exam

    • prism, pinhole, glare & pd support

  • Exam features

    • header w/ exam type and:​

      • date/time​

      • multiple other providers (specialty labeled)

      • location, provider, technician (editable)

    • chief complaint w/ HPI (status/quality/severity)

      • system & user defined complaints/problems​

      • history; view, update/copy forward

    • PFSH/ROS/Lifestyle-integrated online

    • allergies with update/copy forward

    • medications-one click entry from eRx all provider meds

    • prelim tests-the usual plus:

      • height/weight/BMI​

      • BP, pulse, temperature, respiration

      • pulse oximetry, blood glucose, HbA1c

    • Screening tests-billable and coded

      • Optomap, retina, VF, ​OCT, topography, etc

    • Other tests-non coded/non-billable

      • motility, gross VF,  color vision​, pupils

      • amsler grid, dry eye, neurological, auscultation

      • contrast, glare, sinus, staining

      • low vision, developmental, VT

      • any other sub specialty care

    • binocular vision testing w/ change/copy forward

      • near point fused X cyl, dominance, NPC, NPA​

      • AC/A, aniseikonia, cover test, phoria by type

      • fusion, NRA/PRA, stereopsis, vergence

      • user defined tests per exam template​

    • physical exam support to reduce clicks

      • well vision & problem oriented exam support

        • well vision design for well exams

          • all normal selection box

          • refraction automate assessment/Rx

        • problem based design-medical exam support

          • severity based problems selection automates:

            • ​findings, assessment, plan, treatment

            • orders, procedures, special tests

            • interpretation & reports, op notes 

            • all with only a few clicks

    • Orders support 

      • perform, schedule, recall, referral for​

        • meds, exams, consults, special tests, surgery​​

    • ePrescribing ~ look for comprehensive features

      • Rx checks​

        • drug-drug, drug allergy, drug disease​

        • drug-pediatric, drug-geriatric

        • drug formulary w/ pricing information

        • push to patient; coupons and drug info

      • insurance interface

      • ePA (auto prior authorizations)

      • provider renewal alerts

Google reviews ~ automated!

Automated patient surveys following the exam is critical to updating Google and Yelp reviews.  The importance of reputation management cannot be overstated.

Web site design ~ Critical to success
Submit claims day of exam!

Inputing correct demographic and insurance information is vital to getting claims out the same day of exam

It takes less time to input correct information once than inputing and replacing incorrect information later

There is no excuse for bad data!

Selecting the right EHR for your practice is perhaps the single most important decision you will make for your practice.  I encourage all physicians to make their decision based on what you need in the exam room rather than what your office staff wants.  

Rarely do office staff have the long term picture in mind.  It amazes me how many doctors allow their staff to choose their software based on what they want in the PM side.  Long after our employees are gone we will still be stuck with their decisions that may not be in the long term intersest of your practice.

Certainly get your associates impressions about the systems your are considering but I encourage you to make the decision on you system selection based on the EHR that best fits the doctors workflow.

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