Most urgent cares have adopted an electronic medical record (EMR) software in the past several years. This switch in patient data recording has challenged providers into a new way of thinking — how to document without paper.
This digital revolution is transforming traditional healthcare processes and re-inventing them in a new medium. EMRs present new advantages unavailable before, such as real-time data and safety alerts. However, EMRs also pose the need to bridge the world of the past with that of the future.
How does an urgent care go from paper to electronic in a smooth manner? The switch itself is as much mental acceptance as it is learning a new physical routine. As an EMR vendor, we know the most successful transitions take place with clinics that focus on the improvements — and fully commit to change.
Planning makes everything smoother. Once your urgent care has decided to switch, it’s important to lay out a plan to transfer your current workflow to a digital format. Look at your workflow and envision what that will look like without paper. Remove every piece of the paper in your process — from registration through billing — and see what that requires your staff to do and re-learn. Scanners, tablets, and computers will become your staff’s go-to tools.
During the beginning stages of switching, include staff from each department of your clinic in the process of converting — so each role has a voice and can lead excitement for the change. Designate super users in the EMR so department leaders can champion changes in the EMR that better the whole workflow. Train staff to be mentally ready to remove the paper crutch from daily tasks. Envision the computer or tablet as the new clipboard.
Discuss with staff the new needs for communication that an EMR will present. Rather than paper changes triggering workflow tasks, staff need to look for updates within the software to know the next steps to take in the patient visit. Training on digital documentation, per staff role, also ensures procedures are followed for HIPAA compliance — and helps visits be coded and billed correctly.
Consider the implications using an EMR will have on your billing team, as they’re likely not using a fully paper system. Ensure the EMR and/or practice management data will be transferred to your billers smoothly so reimbursements and revenue stays on track.
Transitions require preparation. But even the best planning might not catch all the details you might have overlooked when switching to an EMR. Experiencing lessons through trial and error might be the way you have to learn — if you don’t have guidance from others who’ve already made the switch. Be patient with the learning process and stay the course by setting a time frame for the transition period.
While the transition period may differ per practice, it’s a good rule of thumb to make the transition time a firm date range. In our experience, we know the switch can be successful in 30 days. While you may be more comfortable with a longer time period, the longer you extend the time — the more your staff will rely on paper, rather than learning the new EMR. Stick to your time period, and work through the learning process together.
Your EMR vendor can help with a lot of the legwork by configuring data into the EMR, such as payer info, fee schedules, and pharmacy lists. Take advantage of your EMR vendor’s configuration services so you don’t have to manually enter data into your EMR. Reframe how your clinic views paper by seeing it as only a last resort if the EMR, or your internet, goes offline.
Now that you’ve gone digital, what do you do with the old paper charts? And what do you include in your new EMR? Urgent cares by nature do not have consistent repeat visits like primary care providers do. Therefore, patient demographics and records fall out of date quickly and are less relevant for episodic care. Experity recommends not entering old patient info if you have less than 60% repeat visits.
However, your urgent care should scan in relevant files for reference — and have them easily accessible within a digital folder. Generally, the last two years of charts should be kept on hand. According to the Centers for Medicare and Medicaid Services, HIPAA law requires archives of medical records for patients for a minimum of six years from the anniversary date of the last treatment. You’ll be required to keep workers’ compensation records for even longer.
Record archives may be kept on-site or off-site, carefully consider which files you’ll want your staff to have quicker access to. Put a plan in place for destroying paper files when appropriate. This should be in a reasonable time frame after records are no longer needed and all vital data has been saved within the EMR. Adhere to state laws for proper record retention formats, and clearly communicate how and when records will be destroyed to your entire staff.
New processes often need refinement. Once you’ve switched from paper to your EMR, take a step back and look at your digital workflow. Are templates in the EMR working to their max potential for your providers? Is staff doing additional work that the EMR could do for them? Don’t be afraid to tweak workflow as you begin using your EMR.
Mentally prepare your staff for slight changes to workflow for the first few months. Don’t feel bound to your previous paper workflow — or the workflow you first create in your EMR. View workflow creation as something you can alter and improve as providers’ needs change or as services are added to your urgent care. Document your workflow so your staff can visualize the complete patient visit using the EMR. You may decide to add or remove interfaces in the EMR as well; keep staff up to date on expected changes and train them on new steps as they are added.
Create EMR training documentation as needed to keep staff current with clinic policies and procedures — and to reduce frustration. Your EMR vendor should also provide EMR training for updated software features and functionality that could improve workflow. A periodic audit of workflow by your EMR vendor is also recommended — typically six months after your transition — so your urgent care can be sure it’s using the EMR to its full potential.
This kind of transition is an undertaking, and there is a lot to cover as you move forward. Here are just a few things you should keep in mind for a smoother process.
If you’re using paper records, the challenges of converting are probably not only clear to you, but also part of the reason you’ve stayed on a traditional path this long. Still, it’s important to know a few major hurdles to anticipate so you can be best prepared.
Cost: The cost of transitioning to EMR can be a significant barrier for some providers, particularly small practices. Talk to your prospective vendor about ROI and how you can get the best value from your software. Additionally, ask for advice on your revenue cycle management. Many urgent cares don’t realize how much money they’re losing or not recouping because of holes in the billing process.
Here are a couple of blogs that can help you get started:
You can also improve revenue by treating higher-acuity patients with the staff you have. Learn how in our eBook How to Revive Urgent Care Revenue Through Higher Acuity
Training: Training staff to use the new system can be time-consuming and expensive. Ask your prospective vendor how long onboarding usually takes, how intuitive it is to learn, and what initial and ongoing training resources they offer. If your staff cannot easily adopt the new software, they will not only be more resistant to change, but exacerbate the bottleneck that is the new technology.
On top of that, try to incorporate training in a way that creates minimal disruption to your business and the lives of your staff.
Resistance to change: Yep, in case you’re skimming, we’re saying it again. If you just can’t get buy-in from everyone and are left with some resistance, consider other incentives. Whether that’s something like a group reward once all staff is trained, individual rewards, or something else, it can help motivate stragglers and shorten your adoption time.
Adopting EMR technology in your urgent care benefits your business, staff, and patients in huge ways. And the cost of not modernizing your practice can be equally huge. Here are some of the top selling points of moving to an EMR.
See more patients in a day: EMR systems help streamline administrative tasks, reduce paperwork, and improve workflow. This is even more true when you use an EMR/PM built specifically for urgent care. When you have a smoother, faster processes, you can reduce your door-to-door time and fit more patients in. Which means greater revenue opportunities for you.
Free up more time for staff: With a more efficient workflow, you also spare staff from staying late to finish charts and other work that fell behind because of manual processes. And you’re minimizing mundane tasks that wear on already fatigued employees.
Provide better patient care and yield better patient outcomes: EMR systems enable better communication between providers, staff, and patients, which can help improve care coordination and patient outcomes. Additionally, the efficiencies mentioned above give providers more time to spend with patients, improving patient care and the patient experience.
Make smarter business decisions with operational visibility: Manual record-keeping means manual data entry and clunky reporting. Your EMR/PM tool can generate reports that give you insights into performance so you can determine where you need to focus your energy.
Stay relevant with a modern patient experience: As the world becomes more dependent on technology, your patients expect to be able to do more with you digitally. EMR/PM systems let you do more before and after the appointment — like send text reminders with a link to their bill — and provide a gateway for patient engagement technology if you want to incorporate pre-registration, let patients claim a spot inline before coming in, and other modern conveniences patients expect today.
When it’s time to demo solutions, be sure to include the only one that is purpose-built for urgent care. See how Experity can not only improve your practice, but partner with you for long-term success. Or, if you’re not ready to demo software, check out our blog on choosing the best EMR for a small practice.