Tricia Frank, RN, BSN is the administrator for Empire Surgery Center in Bakersfield, Calif. Recently, the ASC transitioned to a new EHR system. Here, Ms. Frank talks about her ASC's experience with the EHR, and how she'd like to see ASC operations change moving forward.
Note: Responses have been lightly edited for style and clarity.
Question: Can you speak a little about transitioning your ASC to a new EHR system? What challenges did you face?
Tricia Frank: Before we transitioned to an EHR, we were still glued to paper-based charts for our procedure coding, operative reports and nursing note documentation through the first half of 2019. Thankfully, in June 2019 we implemented Modernizing Medicine's EHR ASC solution, modmed ASC. Our process pre-EHR, was complicated and tedious to say the least. I was anxious about the transition, but also excited for the long-overdue change.
My biggest concerns were staff acceptance and whether the electronic system would truly help simplify our current process and increase efficiency. Our nurses and ancillary staff took especially well to the system almost right from the beginning. Our anesthesia providers were the ones who were most resistant to change at first, but once they saw how much less time they would spend on documentation they became much more open, and even expressed that they enjoyed using the system.
Building the charts to match our workflows while remaining compliant with local, state and federal regulations were definitely areas that proved a bit more challenging. Utilizing my knowledge of ASC administration, combined with the support and innovation from Modernizing Medicine’s invaluable customer service team, I feel we have created solutions that have helped us in our compliance efforts and streamlined our workflows.
Q: How does technology help you streamline ASC communication/operations?
TF: Using Modernizing Medicine's EHR in both our practice and now our ASC has streamlined the flow of information between the two locations. It may seem like an insignificant change, but we've eliminated intra-office envelopes. Modmed ASC has streamlined communications within our ASC and between our facility and its referring clinics and local physicians offices. Everything from the smallest of details — making pre-surgical chart checks, direct messaging and faxing of surgery documents directly into the system, and obtaining and timestamping signatures on pre-surgical clearances, surgery orders, and discharges — all takes place with just a few clicks of the keyboard.
The ability to customize our surgery forms and charts for the various types of procedures performed at our facility has been a significant improvement for us. For example, we no longer use the same standard chart for cataract extraction with IOL insertion as we do for blepharoplasty procedures. The customized chart components that apply to the specific procedure type have been a welcomed improvement over paper forms.
Q: Has your ASC embraced price transparency? If so, how?
TF: At Empire Surgery Center, we have a surgery scheduling department that places high priority on providing patients with a good understanding of their options as well as accurate out-of-pocket cost expectations. It is important to us that we ensure our patients are aware of all costs associated with their procedure prior to consenting and scheduling their surgery date. Once the schedulers have obtained prior-authorization and information regarding eligibility and benefits, co-insurance and deductibles, every patient receives customized pre-surgical counseling on cost details as well as their individual financial responsibility. Our goal is to provide our patients with all the available options in an attempt to help them find a surgical solution that fits their individual financial needs.
Rather than providing a broad list of general prices that can be highly variable, we feel that this one-on-one expert counseling is imperative to helping patients understand their options and take an active role in their healthcare decisions without any 'surprise' costs or fees down the road. We certainly haven't ruled out publicly sharing the price ranges of procedures performed in our facility, but until we can find a way to provide the most people with the most accurate price of cost and service quality in a way that they can comprehend, we will continually use our surgery scheduling department. They will provide individual and thorough financial counseling to every patient who presents to schedule a procedure at our facility.
Q: How would you like to see the ASC industry change as a whole?
TF: No more paper. Period. I can't begin to explain how wonderful it has been to simply log into our ophthalmology EHR system and quickly retrieve all the information I need without having to sift through paper-based folders or burden my staff with requests. When dealing with paper charts, it used to feel difficult to ensure proper medical record documentation, retrieve data required for regulatory compliance and to identify processes that might help with patient safety or overall efficiency in our ASC. I can’t imagine going back to paper and hope other facilities will see the benefits and explore technology that can truly help improve multiple facets of their practice. Change can be challenging but the long-term impact on the health of our patients and our business are well worth it.
Q: What ASC trends do you think other administrators should know about going into fall?
TF: I think increased price transparency ahead of patients' procedures will be a hot topic along with how ASCs can continue to enhance the patient experience by providing not only top-notch medical care, but quality customer service as well. Patients are consumers and with the consumerism of healthcare and on-demand access becoming the norm in most other aspects of our lives, patients' expectations from healthcare will continue to raise the bar and rightfully so.
With the projected expansion of the ASC-Payable List by the CMS in November, the ASC industry will experience substantial and consistent growth as more products move out of the hospital and into the outpatient setting.
Technology will continue to reign supreme and be crucial in the ASC space for improved inventory and budget tracking, efficiency monitoring and improvement, and overall patient safety and satisfaction. While we're all busy operating a business, we have to remember not to lose sight of the main goal — providing quality care and service to our patients.
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