Robot surgeons, gamified healthcare, and EHRs on smartphones and tablets may not sound like Asimov’s vision of the future, but compare a passage from Foundation with healthcare IT Google search results for a different perspective.
We’re not too far away from the societies he envisioned. The difference is our views and interpretations of the world grow inward, becoming more specific, with new technologies shrinking in size but growing in scope.
The roles of physicians have also grown inward. Doctors specialize in fields, be it pediatrics or oncology, and often times things get a little more specific – doctors could be cardiologists or cardiac surgeons, and some may specialize in the treatment of congenital heart defects or coronary artery disease.
Electronic health record developers have struggled to mirror this zoom effect, resulting in inefficient EHRs that often fall short of catering to certain specialties.
Specialties and the EHR Landscape
As the pool of electronic health records increases, so does competition. This heightened competitiveness results in less specialty specific systems, encouraging developers to incorporate more flexible options within the system that practices can customize.
Naturally, this problem has arisen and a number of companies are moving to remedy it. An Obstetrics and Gynecology practice, for instance, will need to schedule and bill for pap smears, but not prostate exams. Specialty specific templates should calculate due dates, contraception history, and ultrasound analysis capabilities.
As a physician or office manager, you must have a system that is fully adapted to your needs, with a detail-oriented workflow capable of handling your practice’s needs. Specialty-specific workflows enhance productivity, so finding an EHR vendor to accommodate your oculofacial or chiropractic practice is imperative.
Is seeking a specialty-specific EHR the right answer for your practice?
Problems with Specialty-Specific Systems
At first glance, specialty-specific EHRs sounds like a dream. If they can function as effectively as the best multi-specialty systems, then why not opt for oncology- or hematology-specific EHRs? They’re so different from each other that a one-size-fits-all EHR can’t possibly accommodate both, right?
The answer is a bit more complicated. Well-constructed multi-specialty EHRs can accommodate dozens of specialties via flexible functionality and integrated plugins while providing a more robust and reliable workflow and boasting a stronger market presence, which brings us to our first point.
Unreliable market
A specialty-specific EHR may have the same (or more) functions, tools, and features as a larger, multi-specialty system, but their limited market could compromise growth and stability for your practice.
Do you really want to switch systems just a year or two (or less) after implementing your new EHR, losing money and time in the process? Try asking vendors to show you how their product performs in specific specialties. This will help you rule out what multi-specialty systems are best for your practice.
Interoperability
As a physician, you know it’s only a matter of time before your practice joins a health information exchange. HIEs are like LA highways, a series of interconnected pathways that meander and sometimes cross over and underneath each other while cars travel from A to B.
Specialty-specific EHRs can rarely fit comfortably within these HIEs, rendering them unable to compete with multi-specialty EHRs equipped to handle your fast-paced data exchange needs.
Rigidity
The lack of workflow flexibility is another issue pertaining to specialty-specific EHRs. Many times, these systems don’t offer the configurability and flexibility a full EHR does.
In other words, physicians will be forced to abide by a predetermined workflow that won’t cater to your comfort and habits. Have you ever met two doctors that operate in the exact same manner?
Advantages of Specialty-Specific Systems
Abhay Mishra, assistant professor of health administration at Georgia State University, found a 25-33% drop in productivity among family medicine, pediatrics and internal medicine practices using multi-specialty EHRs.
Mishra’s team suggests the results may lie in different workflow requirements among the three specialties. Essentially, their EHRs make reviewing data more efficient, while entering data becomes more of a hassle.
There are a few compelling pro-specialty specific arguments.
Time and Effort
Writing a comprehensive library of clinical content around which doctors can specialize their system takes approximately four hundred hours. Think of how expensive that is, given the value of physicians’ time.
Simply put, there is no time for physicians to customize their multi-use EHRs. Purchasing a specialty-specific system may be the most efficient route, particularly for specialties like oncology, which need ultra-specific functions.
Comfort
Most EHRs were specialty specific until vendors began developing systems to cater to enterprise level accounts, a trend that was augmented after the inception of Meaningful Use incentive programs.
Using EHRs has become less natural for physicians since then, and there is a fear this problem is spreading as practices scurry to implement systems before their incentive deadlines and fail to fully vet EHR vendors.
Difficult Specialties
There are a number of specialties that simply require more than what a general EHR can do for them. Take nephrologists, for instance. In order to satisfy the specialty’s 50% rule – meaning fifty percent of patient encounters must be documented in a certified EHR – specialists need to take their system into the dialysis clinic.
It’s important, then to support dialysis activities, provide an MCP dashboard and analyze relevant data for nephrologists and assistants to look at.
Essentially, the debate over specialty specific EHRs boils down to the kind of specialty. Your primary care physician may do well with the multi-specialty EHR a cardiology clinic is using with the appropriate templates, while rheumatologists may prefer a specialty specific system.
Which do you prefer and why? Do you think specialty specific EHRs will make a comeback? Check out our EHR Buying Guide for more information on purchasing an electronic health record!
Do you know what you need when setting up a new medical practice?