Top 5 Ways How Optimizing EMRs Can Better Reflect Care & Quality


By Andrew Su

It is well known that electronic medical records (EMRs) help providers better manage care for patients and provide better healthcare decisions. They have advantages over paper records. For example, EMRs allow clinicians to:

  • Track clinical data over time;
  • Easily identify which patients are due for preventative screenings or checkups;
  • Check how their patients are doing on certain parameters, such as blood pressure readings or vaccinations; and 
  • Monitor and improve overall quality of care within the practice.

Put simply: EMRs are digital versions of the paper charts found in a clinician’s office or hospital. However, sometimes the information in EMRs don’t travel easily out of the practice. In fact, a patient’s record might even have to be printed out and delivered by fax or mail to specialists and other members of the care team.  

Optimizing an EMR that accurately captures chronic conditions in an outpatient setting can go a long way in greatly improving mortality and quality scores – that’s, of course, if the outpatient EMR or inpatient EMR are integrated on the same enterprise stance of a single EMR.

5 Keys to Optimizing EMRs

The healthcare landscape has evolved dramatically over that last decade, especially in terms of financial and quality incentives and the capture of patient information. This transformation is partially driven by the Affordable Care Act (ACA), which began to align payments made by the Center for Medicare and Medicaid Services (CMS) with outcomes from the Hospital Compare Star Rating measures. The Hierarchical Condition Category (HCC) risk-adjustment model is used by CMS to estimate predicted costs for Medicare beneficiaries and the results directly impact reimbursement and CMS Star Rating measures.

Additionally, the methods of data capture were reformed with a push from providers adopting and demonstrating meaningful use of EMRs by American Recovery Reinvestment Act funding to maintain existing Medicaid and Medicare reimbursement levels. Therefore, it has become imperative that providers and facilities maintain robust EMR systems to collect data—accurately—around patient care, which is used to reflect the quality of care provided. 

To be successful in this new landscape, below are five key steps healthcare organizations can follow to ensure that clinical documentation and data accurately reflect the clinical needs and diagnoses of patients.

  1. Establish a robust Health Information Exchange (HIE) with all outpatient facilities affiliated to the health system. Providers who are not on the same enterprise EMR system have a wealth of HCC diagnosis data that manage their patient’s chronic conditions.
  2. Ensure a patient’s problem list is up-to-date, accurate and has the correct diagnosis codes that are considered to be HCCs. This can be achieved by implementing or optimizing decision-support tools that assist the provider with managing the problem list. With Fast Healthcare Interoperability Resources (FHIR) as the new HIE standard, managing a patient’s problem list is more vital if it is to be exchanged with different healthcare facilities caring for the patient.
  3. Optimize EMR tools and create real-time reports with pertinent data available that conveys the information in a clean and concise manner. Providers are bombarded with tons of information. Much of it may not be relevant or it may be too entrenched in the EMR that they don’t have time to find it.
  4. Initiate a robust EMR training curriculum that focuses on workflow instead of just functionality of the EMR itself. Providers are trained where to click and where to document, but an EMR training curriculum that combines both functionality and how it relates to their workflow will see a better adoption of the EMR or new changes.
  5. Educate and communicate to providers to help them understand that the new changes will benefit their own reputation and ranking scores and not just the healthcare system.

About the Author:

Andrew Su is a Manager with Dacarba LLC, a subsidiary of Opportune LLP, specializing in the field of healthcare IT. Prior to Dacarba, Andrew served as an Epic consultant and advisor to hospital operational leadership and clinical leadership to prepare and transition to Epic. Andrew is certified in Epic Ambulatory, Epic Security and Epic Orders modules.

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