Tips on choosing and implementing the right EHR for your ASC

Chuck Meisel, vice president of sales at Surgical Notes, discussed how to successfully approach selecting the right electronic health record solution for ambulatory surgery centers and be better prepared for an increasingly electronic future in a webinar titled "Considering an EHR? Tips for successful approach to selecting and implementing the right solution"."

ASCs are not required to have an EHR, and CMS likely won't implement any such mandate. There is not currently an approved "meaningful use" standard for EHRs in surgery centers. However, if HR 5556, the Electronic Health Fairness Act of 2014 is passed, ASC physicians will not be penalized for performing cases in an ASC without EHR.

The Senate also announced a bipartisan working group to find ways to improve EHRs.

"This ties into a bigger picture, tied to when we look at total expense and if we were to move to an EHR in the surgery center, it is a big expense, and it's got to work at the center, the practice and the hospital level," said Mr. Meisel.

While many ASCs are considering EHR—and likely will need one down the line—not every ASC has one. Only around 10 percent to 15 percent of the market has an EHR today, according to Mr. Meisel. However, EHRs can:

• Increase the profitability of your center
• Reduce labor costs and save money
• Free-up your staff to improve patient care
• Enable you to report on your clinical outcomes, which should result in increased reimbursement and/or profitability.

In terms of the overall market today, Mr. Meisel says it’s getting tougher and tougher for ASCs, but they are still providing outstanding clinical outcomes and are tremendously efficient and profitable. IT purchases can increase the bottom line in a 12-24 month period.

"For example, you wouldn't buy new GI equipment in the hopes that a gastroenterologist will come to your center; you would have done the ROI tied to reimbursement and assessed that bringing this equipment in with this number of cases, that we're going to end up with this much revenue and this much profitability, which would have paid for the system," said Mr. Meisel. "Same thing when you are looking to buy an EHR."

Here are some functions of the EHR according to the presentation:

• Document what your nurses and physicians are doing in checklist form

• Increase safety
• Track staff and document for AAAHC surveyors
• To demonstrate the policies and procedures were adhered to in case of a sentinel event

Mr. Meisel suggested ASC leaders look to reduce expenses, lower costs per case, gather and use better business analytics and increase patient involvement.

ASC leaders can compare products by asking for a demo, presentation, educating partners or owners and establishing a budget. A key feature to the EHR, Mr. Meisel notes, is completely eliminating paper.

"You'll also want to have a standard report generator that can be customized by a lay person," said Mr. Meisel regarding EHR must haves. "You don't want to have to have a PhD in crystal reports."

Other EHR must-haves, according to Mr. Meisel include:

• Ease of use
• Allergy alerts
• Operative reports flowing directly into the chart
• Automatic auditing capabilities
• Soft and hard stops tied to missing documentation
• Ability to add the physician post op note
• A hosted solution versus a server based solution
• Subscription model
• Interoperability, from physician's office to the center, the center to the office or to a hospital if necessary

Mr. Meisel advises to look at the expenses and capital investments, including travel and training as well as savings, including paper elimination, labor, reporting, and storage to calculate return on investment.

Mr. Meisel gave an example of an ASC that was in the black over a 12-month period with $38,000 in savings.

"At an average of $350 in net profit per case, that equaled the profit created by 109 new cases for that particular center. In a center that averages 300 cases per month, this is a 3 percent increase in case volume for the year without needing to find an additional 109 cases, and that came without having to find labor, supplies, etc," said Mr. Meisel.

You and your staff can decide what would be best for your ASC and do the due diligence to pick a solution that will pay for itself, while understanding that compromises will have to be made, concluded Mr. Meisel.

"In the end, I think we'll all end up using what the government decides on anyway," joked Mr. Meisel. "But in the meantime, pick the products that work best for your staff, your center, and your physicians."