FEATURE
cal patterns; optimize scheduling of patients, surgeons, rooms, staff, equip- ment and anesthesia personnel; and make the most appropriate decisions on staffing and purchasing, all while improving outcomes.
An EMR also helps streamline a
surgery center’s processes. ASCs no longer need to rely on dedicated staff members to be in charge of filing and recordkeeping. An EMR streamlines such tasks, and anyone in the facility can access and pull records when an EMR is in place. ASCs can reassign the staff members once responsible for these roles to other positions. EMRs have many additional fi- nancial benefits. ASCs will realize immediate savings by cutting out the cost of storing and retrieving paper records and the cost of paper itself. One West Virginia surgery center uses its EMR to establish correct par levels and decrease the amount of on-site inventory since the system indicates the surgeons’ needs based on preference cards.
Improvements in Efficiency EMRs can play a significant role in improving efficiency throughout an ASC, and improvements in efficiency typically translate to more time to focus on providing quality care, better use of resources and happier physicians.
An EMR will help decrease the number of staff hours required for many tasks previously tackled through a paper system. With more available time, staff members are able to devote more attention to patients and can be assigned to areas of the ASC in need of additional support. One Tennessee facility uses its EMR to improve ef- ficiency in many of its auxiliary func- tions. By using the EMR, the ASC has been able to automate pathology orders and have the results returned electronically. The system has allowed the ASC to eliminate other manual
tasks, helping to cut costs by reducing time and effort, and improving qual- ity by eliminating manual processes more likely to trigger human errors. The usefulness of an EMR extends into the operating room (OR). Sur- gery centers report that they have seen notable improvement in the efficiency of charting. With an electronic chart in front of surgical team members, they can chart quickly, accurately and completely, and everyone on the team can view the information. ASCs can also take advantage of template tools included in an EMR. Such templates can be used to create charts specific to different specialties and procedures and eliminate the need to fill out repetitive information once it is standardized in the templates. This standardization helps improve chart documentation and completion, and is particularly helpful for centers with a high volume of quick turn- around cases. One New Jersey ASC has timed its OR nurses and seen that it takes them less than five minutes to fill out their portion of the EMR. Once nurses complete their required docu- mentation, they are able to pay more attention to the patient and what is happening in the OR. This has re- sulted in improved performance of their tasks in the OR and a decrease in wasted resources.
Compliance Improvement ASCs find themselves facing wider and stricter rules and regulations from federal and state agencies, as well as accrediting bodies. The use of an EMR helps ASCs meet requirements
and quickly and easily access all in- formation requested during surveys. EMRs provide immediate benefits during accreditation surveys.
The
center’s leadership is able to quickly access requested survey information through the EMR as opposed to flip- ping through binders and stacks of paper, which is both time consuming and challenging. Surveyors approach surveys with the belief that “if it’s not documented it didn’t happen.” An EMR, through its self-policing and prompts, helps ensure that every step taken and every task performed and completed during a patient’s visit is recorded and, thus, documented. The use of an EMR by one New
Jersey ASC helped its management team bring about significant compli- ance improvements in charting—an area that is frequently a challenge for ASCs. The ASC found that when it re- viewed its signed consent forms, the compliance rate came back at about 80 percent, which the center’s leader- ship deemed unacceptable. Through use of the EMR, that number now does not drop below 100 percent. As part of the new Medicare qual-
ity reporting program, CMS will ask ASCs if they used a safe surgery checklist in 2012 and will, then, make this information public. ASCs can set up their EMR to remind staff mem- bers to use and follow a safe surgery checklist for every procedure. CMS is also requiring ASCs to
report on other quality measures. If ASCs do not successfully report data on these measures to the Medicare pro- gram by specified deadlines, they may face a reduction in their Medicare
ASC FOCUS NOVEMBER/DECEMBER 2012 15
Many surgery centers have reduced patient wait times by more than half by performing a quality assurance study using data tracked by the EMR.”
—Joe Macies, AmkaiSolutions
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