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HIT Advisor

I have known Dr. Ted Arkfeld for a few years and I have been impressed with his unique background and perspective in that he not only understands technology but has seen and experienced, first hand, the successes and failures of more then one EMR. He personally has been in audits which, by itself, gives you invaluable experience and, as a Certified Independent Forensic Examiner, has done many independent audits. He has lectured, written articles and consulted to pain management clinics many times over the years regarding how to maximize reimbursement while offering compliant documentation that minimizes a physician’s exposure. As a C.P.C. (Certified Professional Coder), as well as an Independent Medical Examiner who understands technology, Dr. Arkfeld provides this HIT department with valuable insight. I’m sure you will find his article both enjoyable and informative.

—Greg Winterkamp
HIT Department Head

Ted Arkfeld, MsYou made a commitment to modernize your office and move into electronic medical records (EMR). This required an outlay of monies to cover either new hardware or upgrade existing systems, as well as the new EMR software program. The day when all of the components arrive at the office is exciting and maybe slightly challenging with the daunting task of logistically getting the new system to operate for your practice. The training has begun, and you are now feeling more comfortable with your decision and the EMR process.

However, time is at a premium and you have a busy practice, how much more is this training going to dig into your daily clinical hours? Thus the equation of patient volume versus appropriately documenting comes into play. Like so many offices, it may be easier to settle at a certain comfort level with the new EMR and just utilize the bare necessities to get the charting finished. Or even worse, you are so busy in clinical practice—and this new technology feels so overwhelming—that you decide to return to your former way of charting which may not be efficient, but it sure is familiar and comfortable. When this occurs, the EMR system is perceived as having been flawed and, when conversing with colleagues, you voice your displeasure about the new system. You let them know how much money you just spent and that the system will not work for your practice.

What happened in this scenario is no different from the problem patient who will not follow through with your treatment recommendations and then proceeds to tell everyone that you stink as a physician. We all have had those patients, and heard what they are saying around town. It raises our blood pressures because we know there is another side to the story that no one is hearing. It simply is not fair. So I ask the question, “Are you really utilizing your EMR?”

There are three vital components to implementation:
• Communication
• Appointment of a Project Manager
• Time

On the surface everyone may seem to be onboard, but there can be a tremendous amount of internal dialogue occurring in your office. Internal dialogue is the unspoken thoughts of various staff members. You may be already geared up and ready to launch into electronic medical records but, to your staff, this may be perceived as just another one of your grandiose ideas or your newest toy that is going to require them to work more and even worse, take them out of their comfort zones.

Please refer to the June 2007 issue for the complete text. In the event you need to order a back issue, please click here.

Last updated on: February 22, 2011
First published on: June 1, 2007