Alabama REC and Ophthalmology EMR

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In order to facilitate the adoption of health information technology (HIT), Alabama has one Regional Extension Center (REC) serving physicians within the state. The Alabama Regional Extension Center (ALREC) was created under the Health Information Technology for Economic and Clinical Health (HITECH) Act’s Health Information Technology Extension Program. The purpose of this center is to provide physicians with education and technical assistance necessary to help them improve the quality and value of care they furnish by exceeding meaningful use of electronic health record (EHR) systems. This center is also dedicated to the broader long-term goal of developing Health Information Exchanges.

The first step toward achieving meaningful use of health information technology is the selection and purchase of certified EHR software, a challenging task for physicians due to the sheer number of vendors and the complexity of the many software options available. The Alabama Regional Extension Center can play an important role in guiding physicians through the implementation and use of EHR software the physician has purchased, making the process quicker and more convenient.

Some Regional Extension Centers have also chosen to offer a list of selected EHR vendors (also known as preferred EHR vendors) that have been prequalified or otherwise vetted. These EHR vendors are selected from a group of EMR (electronic medical records) companies that fit qualifications and demonstrated a commitment to the improvement of health information technology. In order to be selected, the electronic health records vendors on this list agreed to a higher base level of functionality and interoperability. This will enable physicians to achieve meaningful use and best participate in the Health Information Exchange. In many cases, Regional Extension Center members may receive group purchasing discounts, discounted pricing, and standardized terms and conditions by the EHR vendors to facilitate adoption quickly and smoothly.

With hundreds of EMR choices on the market, doctors may find it a challenge to select the appropriate software for their practice. In order to maximize your chances of finding the right EMR for your ophthalmology practice, you should look for software that is designed specifically for ophthalmologists or a similar specialty. Ophthalmology EMR software is customized to deal with the unique characteristics of treating conditions of the eye. Ophthalmologists rely heavily on a wide range of ophthalmic instruments to examine and detect abnormalities of the eyes so your software choice should be able to integrate with digital cameras, visual field machines, automated refractors, keratometers, and other devices. Ophthalmology also involves detailed reporting of what is observed from or in images of the eye. As such, Ophthalmology EMR software should facilitate note-taking either through handwriting recognition or touch screen keyboards on tablet computers, or transcription of verbal notes using integrated voice recognition software. It can also be compatible with light-pen mice and drawing pads to facilitate graphical data entry. Additionally, one unique aspect of practicing this specialty is that ophthalmology practices are often retailers of eyeglasses and contact lenses. Most ophthalmology EMR software have point of sale (POS) systems integrated into the software to help with this.

At the start of software evaluation process, you should evaluate potential ophthalmology EMR based on the following criteria:

  • Practice Size: Some software is better suited to small practices, others to larger ones. EMR software is designed for a certain number and type of user, with scalability in mind. Make sure the software you select is appropriate for the number of ophthalmologists in your practice.
  • Systems Architecture: You can purchase Ophthalmology EMR software that is installed directly on your computer servers on-site at your practice (“client-server”) or Ophthalmology EMR software that is located in the “cloud” that you access via the Internet (“cloud-based” or software-as-a-service “SaaS”). Some ophthalmologists prefer client-server based software since they feel more comfortable with HIPAA compliance when they control all the underlying data on their systems, despite the need to maintain and upgrade these systems periodically. Other ophthalmologists choose cloud-based software because it can be accessed almost anywhere through the Internet. However, you are reliant on your Internet connection, so you need to make sure the quality and consistency of your Internet service is high. It is worth reading about all the advantages and disadvantages of each type HERE, to make sure you choose software with the systems architecture that best matches your needs.
  • Certification: When selecting your EMR software, you should make sure that it is tested and certified by an ONC-Authorized Testing and Certification Body (“ONC-ATCB”). The ONC (Office of the National Coordinator for Health Information Technology) is the responsible agency for establishing EMR certification standards and certifying vendor EMR products. ONC-ATCB certification assures that your EMR has met required Meaningful Use (“MU”) objectives and measures. This is a prerequisite to obtaining MU Medicaid (up to $63,750) and Medicare (up to $44,000) incentives for adopting EMR software, and avoiding penalties for not adopting one. To learn more about these topics, you may want to read the following articles:
    • What you need to know about ONC-ATCB
    • EMR / EHR Government Meaningful Use Incentives Information
    • EMR Deadline; Will I be Assessed Penalties for Not Using an EMR System?

Once you have narrowed down your EMR choices based on practice size, systems architecture, and certification, you can evaluate certain features that are unique to ophthalmology practices.

Such features include:
  • ICD/CPT codes specific to ophthalmology
  • Integration with keratometers, autorefractors, visual field machines and other ophthalmic equipment
  • POS to facilitate the sale of contact lenses and eyeglasses
  • Compatibility with digital pen technology
  • Ability to track contact lense information on patients
  • Inclusion of diagrams graphically documenting ocular occlusions and other eye problems

Ophthalmology EMR vendors understand that not all specialties are alike. While there are a lot of similarities shared by all EMR software, you should be able to customize whatever EMR you choose to fit your specific needs.

To facilitate this, ophthalmology EMR vendors offer a variety of pre-designed templates such as ones tailored for:
  • Cataracts
  • Blurred vision
  • Laser correction surgery
  • Glaucoma
  • Corneal transplant
  • Ocular surgery
  • Macular degeneration
  • Chalazion
  • Corneal abrasion
  • Ectropion / entropion
  • Graves’ disease

While selecting a ophthalmology EMR may seem like a daunting task, having familiarity with the basic selection criteria common to all EMR software as well as some of the features customized for your specialty can help you make the right choice for your practice.

Listed below are the preferred EHR vendors recommended by the Alabama Regional Extension Center: