EHR User Series: The Search for EHR Mobility

Like many of my colleagues, over the years I have developed my own unique way of practicing dermatology. Thus, the search for the right Electronic Health Record (EHR) for a medical practice can be a huge challenge, as I discovered. As I researched and sampled different systems, I could not find a system that was customizable or flexible enough to mirror the clinical flow of my office. Instead I felt forced to follow an entirely new method of patient treatment and documentation. Nothing seemed like the right fit for use in my office.

In my extensive search, I found that the market seemed to lack a truly mobile EHR. In my ideal practice scenario, I would access and fully manage my patients from the clinic or anywhere else, at any time, with one mobile platform. But many of the systems I looked at required a desktop to complete all of the necessary tasks regarding management even of a basic dermatologic case. For instance, one of the systems did not even have a daily patient schedule on the iPad from which I could access patients’ charts quickly. I had to constantly switch from a desktop to the iPad many times just to complete one visit.

In March of 2013, during the American Academy of Dermatology meeting in Miami, I was introduced to the EZDERM system. I was impressed by the three-dimensional (3D) anatomical body mapping and other integrated features, such as voice recognition and commands. The 3D map can be moved to any position of the human body, and I could automatically label the location or a procedure by a press of a finger. I was intrigued with its great potential, but I wanted to wait and see how it would progress from its development stage before committing to its implementation in my practice.

FROM TEST DRIVE TO LONG-TERM

In March of 2014, I took EZDERM for my first test drive on a limited number of new patients during each clinical session. I was impressed with the ease of use and complete customization to the way I practice dermatology. During the subsequent month, I started creating templates for specific physical exam descriptions, treatment plans, and patient education, among other parameters. After completing the first two templates, I recognized the ease of customizing the software to meet my needs. Since I already had a collection of paper templates that I had used in my practice, it was simple to incorporate these into the software.

Because I took the time to customize the templates, and I had my staff use the program in a gradual and methodical way, I started using EZDERM much sooner than originally anticipated.

In May of 2014, my associates started gradually using EZDERM and implemented it fully within a month. The transition was easy for my entire office. We were able to document all of the patients in real time, without the need to alter our busy practice schedule. The well-organized and customizable document management system enabled us to import all of our paper charts into the software.

EZDERM complements, rather than interferes with the visits of my patients. The easy-to-use interface enables my assistants to act as scribes during an encounter, enabling me to address the patient’s needs face to face. During the visits, with the touch of a button, I am able to take photos of patients’ skin conditions and lesions. These photos are then saved automatically to the location on the 3D map, in the context of the associated procedure and condition.

In terms of how the system is built for the future, it is also worth pointing out that EZDERM incorporates the SNOMED-CT clinical database that not only supports the current ICD-9, and soon to be implemented ICD-10 coding system, but SNOMED-CT also serves as the foundation for ICD-11. The company has also recently announced the release of an integrated PMS module. As ICD-10 coding is highly location dependent, a coding system that utilizes detailed 3D anatomical maps and an integrated PMS module will be essential for reimbursement.

CONCLUSION

If we were to adopt the long view, no EHR program is perfect and there will always be growing pains. That is why it is important to work with a company that is product-oriented and receptive to requests for improvements to the program. In my experience, EZDERM has addressed my requests on a biweekly basis and the updates are fantastic, and I am very grateful to see my requests incorporated into the software.

In terms of the day-to-day flow of my practice, EZDERM has helped me to achieve a unique efficiency. I am always finished documenting my patients within office hours each and every day, regardless of my patient load. This has helped me make a swift and complete transition in my practice from paper charts to 100 percent electronic medical records in a relatively short period of time.

Barry Galitzer, MD, FAAD is a board-certified dermatologist who practices in Fort Lauderdale, FL.

The EHR User Series is a periodic feature of the Digital Practice department, in which physicians offer pearls based on their experience with an EHR. To submit your own entry, email tpigeon@ bmctoday.com.