Running a promising dermatology clinic means continuously seeking ways to enhance patient care quality and maximize staff efficiency. For proof, consider that over 40 percent of practices claim to have implemented EMR systems to help them grow.
While implementing an EMR system for dermatologists has many advantages, there are still some disadvantages to consider. This article will look at the pros and cons of electronic medical record systems for dermatologists, including reducing paper, image management, billing, lab interaction, and EMR limitations to ensure you have the facts when considering ways to maintain quality diagnosis and patient care.
One main advantage to an EMR is the ability to access your notes and patient information anywhere. In an increasingly digital world, we are often communicating with patients while out of the office. Still, 25 percent of dermatologists continue to use traditional paper systems to support their operations.
Here are some of the standard paper shortcomings and the ways an EMR system solves them:
- Repetitive tasks: Completing the same functions repeatedly takes time and energy away from vital patient interaction. In addition to autopopulating fields, an EMR sends data electronically, so it doesn’t have to be re-entered.
- Errors: Entering and re-entering data into the LIS introduces the possibility of human error. Entering data one time using an EMR removes the chance of making mistakes on repeat entries.
- Access: Pulling a patient’s paper file can only be done in the office, requiring time and physical space to store the physical records. Using electronic medical records means patient information is stored securely in the Cloud, which providers can instantly access from anywhere with a Wi-Fi connection.
Unlike paper, EMR systems make it increasingly advantageous for dermatologists and their staff to do things more efficiently and conveniently. It is important to ensure staff is adequately trained on a new system and receives regular review sessions to maintain a good standard of EMR charting, as updates occur several times per year.
Patient images in dermatology are valuable, as much of the specialty relies on visual recognition. It is also important when tracking the correct site of a biopsy, especially for referring to other providers like Mohs surgeons.
Digital images are easy to capture, but often cumbersome to organize. If not using an EMR, these will have to be organized in folders with patient name and date and kept in a secure digital environment. Many EMRs resolve this arduous process by allowing you to take photos within the patient chart and automatically assigns the images to the correct biopsy location. These images can be accessed immediately, making it easier for dermatologists to share them with partners and patients or review them on the next visit. Also, being able to review them in the context of your visit with relevant labs and other notes helps in diagnosis, especially of difficult cases.
While necessary, billing is not the favorite activity of most providers. However, billing takes time and diligence to communicate with insurance companies and resubmit claims when appropriate. With that in mind, another benefit of electronic medical records is the autobilling feature.
Many EMRs will issue invoices based on coding applications. In addition, some EMR systems claim up to 98 percent first-pass claim acceptance, which means you and your staff can spend time focusing on patient care instead of going back and forth with insurance companies.
Also, EMRs automatically track any changes to Medicare’s Merit-Based Incentive Payment System (MIPS), ensuring your practice receives accurate reimbursement for qualifying services. This eliminates manual tracking and helps you to maintain focus on patient care.
Communication with your dermatopathology lab partner is vital to ensure the highest quality of diagnosis for your patients. Full-service dermatopathology labs like PathologyWatch will integrate an EMR interface, which allows them to access the data and fields entered into your EMR system.
Equally important, an EMR interface grants you instant lab results and images sent directly to your device. The EMR also helps you send e-faxes to providers or drop notes directly to the patient’s record, instead of requiring your staff to print out, fax, scan, and wait for a confirmation.
While EMR systems embed many time-saving and workflow advantages, they also contain quirks and constraints that users learn to navigate. For instance, 82 percent of physicians indicate it takes too long to enter data that isn’t directly related to patient care.
The EMR could also make it difficult to communicate outside of the prescribed default descriptions. Thus, if you indicate eczema when you’re trying to describe a rash, it may take you longer to type in a custom description than selecting the available options. To make the system work right, you have to be willing to customize your process with templates, adding quick text or macros when possible to aid in customizing each note, and take time to delete unused or irrelevant items within your templates.
Sometimes, adding digital elements can create slow-downs if the interface is down or you experience an error after an update, for instance. This can be challenging if you can’t print out a requisition from your EMR or can’t access patient records while you are seeing patients in the clinic.
In the end, the benefits of implementing an EMR into your dermatology practice often outweigh the disadvantages. By understanding how EMR systems can reduce your reliance on paper, manage images, increase billing efficiency, and boost lab communication, your clinic can make a qualified decision that can help you continue to provide quality care for your patients.
Across America, healthcare industry professionals play pivotal and often pressure-filled roles in keeping individuals and communities safe. However, this commitment to service comes with a toll in the form of heavy turnover rates. One two-year study found that family practices experienced an average turnover rate of 53 percent. Now is the time to ensure you’re running a motivated and efficient dermatology clinic staff.
While tending to patients is every dermatologist’s most critical concern, maintaining a productive and satisfied staff isn’t too far behind. By increasing your team’s high-level patient contact, sharpening your staff-retention efforts, and making sure you hire qualified individuals, your practice can continue to administer the level of care your patients have come to expect.
High-Level Patient Contact
Expanding individual responsibilities can improve staff morale while helping to reduce your workload. Since medical assistants represent the biggest group of individuals providing clinical support to dermatologists, increasing their contact with patients can result in more time for you to address other priorities.
A well-trained MA may be capable of sharing diagnoses with patients on a case-by-case basis. To ensure seamless quality care, do the following:
- Provide staff members with a dermatology atlas to familiarize themselves with more common cases.
- Make sure every patient experience is consistent and professional by developing formal staff training programs.
- Promote knowledge and curiosity by teaching your team about frequent medications and treatments.
It would also help to train your staff to be conduits between your clinic and the dermatopathology lab. While full-service digital dermatopathology labs like PathologyWatch return diagnoses directly to your patients’ EMR, having a staff member that follows up on orders and results is a positive way to keep the lines of communication open.
Spending more time now to retain reliable dermatology staff members means spending less time in the future filling positions and training new employees. Since preventable employee factors are responsible for 80 percent of healthcare industry turnover, here are some suggestions to ensure your team members feel job satisfaction:
Create a comfortable office culture.
Is anyone happy working in a frantic environment that treats every task like an emergency? While there will be times when urgency is in order, do your best to set the example of composure and positivity by setting reasonable expectations for tasks and time management. This includes keeping a level head and being respectful in your actions and speech.
See team members as individuals.
You’re all in this together, so avoid focusing on individual mistakes. Likewise, nobody wants to be singled out or embarrassed in front of others. Be encouraging, promote camaraderie, listen to employee feedback, and find teachable moments to increase efficiency and skills.
Share accolades and rewards.
Small gestures can go a long way. In addition to praising accomplishments with kind words, keep your staff motivated with performance pay or other incentivized bonuses.
Provide employee discounts.
Offer discounts on procedures and products to turn your staff into brand ambassadors. As a result, you can build loyalty from your employees while increasing public awareness.
Creating an environment where people look forward to coming to work benefits your staff retention while leaving a good impression on your patients.
Hire Qualified People
Tending to patients while meeting the demands of running a thriving dermatology practice would be a daunting challenge without reliable staff support. Start on the right foot by hiring individuals with the characteristics and skill sets you require to deliver quality care to your patients.
According to the Bureau of Labor Statistics, the healthcare industry will add nearly 2.5 million jobs by 2029. With a labor pool that size to choose from, make sure you aren’t settling for employees that aren’t going to make long-term contributions to your clinic. Trust your instincts if you don’t feel someone is a good fit for the job’s values, pace, or expectations. If you’re on the fence, suggest a trial period to ensure both parties are satisfied with the duties and performance.
Here are some personality traits to keep in mind as you identify features that translate to a valuable dermatology staff member:
- Ambitious: Your workload can get lighter with the support of enthusiastic individuals who don’t mind shouldering additional responsibilities.
- Personable: Single out people who are comfortable communicating and showing compassion with patients of all ages.
- Teachable: Surround yourself with staff members who are eager to learn and share new knowledge and skills.
- Team Player: Dermatology clinics require staff members to wear many hats to keep the front office and exam rooms working efficiently.
Managing a motivated and efficient dermatology clinic staff requires consistent attention and leadership. By expanding your team’s patient contact level, focusing on staff-retaining actions, and hiring qualified team members, you can surround yourself with the right people to serve your patients.
The healthcare industry is becoming increasingly convenient for patients with the rise of telehealth and greater access to medical records. Patient portals are now offered by nearly 90 percent of providers. While convenience is important, it is critical for your dermatology clinic to develop a personal touch and sound communication strategies for talking about diagnoses with your patients.
By taking the time to ensure your patients understand their diagnoses, training your staff to help share results, and knowing how to discuss diagnoses, you can help your practice keep patient experience and treatment a priority.
Taking Time to Educate Patients
Walk into a busy dermatology clinic and you will find staff members moving briskly to attend to patients, communicate with labs, manage the billing, work with insurance companies, and schedule out calendars. On top of this, the dermatologist balances limited time bouncing between exam rooms to take biopsies and guide treatments.
However, when it comes to sharing biopsy results, it’s vital to shift gears and take the time to help patients receive and understand the information with clarity. Because only 12 percent of patients can interpret their pathology report results correctly, dermatologists must be vigilant to ensure each patient leaves with an accurate comprehension of his or her condition. Here are a few suggestions to help engage the patient in their care.
Name their condition
By writing down the diagnosis and explaining it carefully, even if complicated (think CNH or GA), patients’ understanding and recall of their conditions improve. This correlates with increased patient satisfaction and adherence to treatment. Studies also show that patients forget 40-80 percent of what you tell them, so written communication is often best.
Give them a copy of their pathology report.
Consider printing out a copy of their pathology report. Having them read along as you explain the results can help to build confidence and absorb information. They will likely feel more comfortable asking questions.
Explain additional tests. A patient who understands his or her test results is likely to comprehend your reasoning for ordering further biopsies or studies.
Empower the patient
The more that patients understand, the more they are able to take personal responsibility for their own health and well-being. Time spent upfront counseling patients can result in improved outcomes, improving both patient and physician satisfaction.
Training Your Staff
The most powerful tool a dermatologist has is a supporting and capable staff. In addition to training team members on front and back-office tasks, you can save valuable time by giving medical assistants more ownership of the diagnosis-sharing process.
Patients want to receive their results as soon as possible. In one study, 67 percent of patients requested phone calls to receive their skin biopsy results because they wanted the information fast. By training and trusting your staff to communicate test results directly to patients, you can use this time to add an acute patient or catch up on documentation.
Your staff is listening as you interact with patients. Ask them to pay close attention to how you counsel patients so they can repeat the process on their own. Train your MAs to use handouts, images, or other devices to convey information in a comprehensible manner. Building relationships of trust by counseling with patients can make it easier and more personable when MAs follow up on treatments.
Your practice management tools can be a costly part of your dermatology practice overhead. New practice management solutions are popping up frequently. With busywork costing physicians an average of $50,000 a year in lost revenue, it can be overwhelming to evaluate the latest timesaving or job-simplifying solutions in a busy practice.
However, by examining your existing practice management tools, such as billing, your EMR, and your dermpath lab partner, you may discover increased efficiency may require some simple finetuning that makes a big difference to your bottom line.
Collecting payment for the work you perform seems an obvious yet sometimes daunting task. A common question for dermatologists is whether to keep billing in-house or use a professional billing company. Each option has its benefits.
The advantage of a professional billing partner is the experience they bring to the table. About 10 percent of claims will be denied, and a high percentage of those (63 percent) are recoverable, so it’s important to resubmit denied claims. In addition to submitting and challenging claims, billing professionals can perform coding audits, credentialing services and potentially negotiating superior rates with insurance companies.
These companies typically charge a percentage of collections, ranging from 5 to 10 percent, and are therefore incentivized to maximize your collections. Look for a company that specializes in dermatology billing and talk to reference clients. Make sure they can work with your particular EMR or PM software.
A common issue for physicians using in-house billers is how to be confident that billing is being performed correctly. There are services that will perform a complimentary revenue cycle audit to ensure that you are maximizing your reimbursement.
Embracing the advantages of a modern, cloud-based EMR system can simplify record-keeping and maintain effective patient care in your dermatology clinic. It’s exciting to see more dermatology-specific EMRs created by dermatologists who understand the unique workflow of dermatology. While almost 86 percent of office-based physicians employ EMR/EHR systems, many have yet to tap into the full breadth of productivity-increasing features.
Look for an EMR company that performs consistent upgrades and frequently informs and educates users about new timesaving benefits. After comprehensive onboarding, keep in touch with your EMR customer service representative to get answers to any questions or challenges your staff may encounter. Resolving performance issues is part of their job description, and it will save your team valuable time. Often, chat or emailing support is the most time-efficient way for staff to reach out for questions or troubleshooting, rather than calling the helpline.
The working relationship between your dermatology clinic and the dermatopathology lab is critical to maintaining accurate and timely results for your patients. This alliance is particularly vital when you consider that a third of dermatologists work as solo practitioners.
One effective way to build this relationship is to establish open lines of communication. This includes providing accurate clinical information on your requisitions, conversations about difficult clinical cases, and correlation on challenging slides, such as alopecia or melanoma cases. In addition to quality assurance, these frequent conversations can also head off complicated billing issues before becoming a problem.
Your dermpath laboratory partner should keep you in supplies so your staff isn’t left scrambling to find requisition or shipping materials. The lab is also responsible for tracking samples from when they leave your practice until you receive the final results.
Finding a lab that establishes an interface with your EMR can make a significant impact on your workflow. Instead of spending time managing paper charts and faxes, a full-service dermpath lab like PathologyWatch can return reports electronically into each patient’s EMR chart. Digital slides are also provided to the clinician along with the pathology report. This instantaneous, 24/7 access eliminates your MAs’ need to track and file paper trails and glass slides, leaving more time for meaningful patient correspondence. Also, labs like PathologyWatch offer broad insurance coverage and locum tenens contingencies, so there is always a backup ready to keep up with your tissue samples.
Many dermatologists carry the daily pressure of meeting patient expectations while running a proficient and profitable clinic. By breaking down ways to make billing, EMR, and your dermpath lab partner work smarter and more efficiently, you may find ways to simplify and improve operations through your existing practice management tools.
Rajni Mandal, MD, is board-certified in anatomic pathology and dermatopathology with degrees from both Cornell University and Duke University. She completed a dermatopathology fellowship at New York University and a surgical pathology fellowship and anatomic pathology residency at Massachusetts General Hospital.
She is a regular contributor to numerous publications in the fields of surgical pathology and dermatopathology and is a valuable consultant and content contributor for PathologyWatch.
We sat down with Rajni to talk about her connection to the dermatopathology field and how this emerging field is impacting patient care.
You had a unique and almost instant connection with pathology. Can you describe that moment?
Early on, I found tumors so engaging—almost beautiful, in a way— when viewed under the microscope. I am fascinated by everything about the process. It was an unusual way of looking at the world, but it was a shared perspective. When I learned that other people had this fascination, I knew I had found my tribe and my calling.
What do you think is the most rewarding part of working in the pathology field?
In pathology, you give a diagnosis that has a direct impact on patient care. When a physician asks for an opinion on a diagnosis, it’s because they are reaching the end of the road to making a diagnosis before a biopsy. So the idea of consulting with pathology as part of the process to pinpoint a diagnosis is what I find most rewarding. I know that my diagnosis is taken seriously and ultimately contributes to that patient’s treatment options and care.
What strengths do you bring to PathologyWatch?
I come from a background of academics and private practice, and this experience has helped in the research and organizational side of the company. My academic experience during training, which included multiple publications, helped me develop a rigorous standard for data collection and interpretation, which has helped in developing the research tools at PathologyWatch. In private practice, I have experience in business development and laboratory startups, and this has served to advise the executive team in laboratory compliance, regulation, and marketing. Finally, I am a committed believer in the mission of the company and enjoy working with this amazing team.
What will PathologyWatch bring to the industry?
The field of pathology is riddled with misdiagnoses and a lack of access to quality care. PathologyWatch will improve the quality of care by facilitating standardized criteria for pathology diagnoses. This is a game-changer in the field and will improve the quality of care across the board. This is just the tip of the iceberg, as digital pathology technologies end up being more cost-effective in the long run, with quicker turnaround time. The benefits will trickle down to other facets of healthcare quickly.
What do you do in your spare time? (Besides being a superhero, of course.)
I am a “binge” reader and love fantasy and sci-fi novels. I once read the last book of the Harry Potter series in one marathon sitting! I also love playing board games with my family (even though I have the worst luck!).
As a dermatologist, you rely on your lab partner to provide correct diagnoses to ensure your patients receive the highest level of care. However, since communication errors are a major factor in up to 70 percent of adverse events, it’s easy to see how better communication with your dermatopathology laboratory can lead to better results.
Producing accurate results is a team effort. By identifying the information required for a definitive diagnosis, developing a communicative relationship, and enhancing communication through technology, you can help your dermatopathology lab consistently produce more valuable reports.
Facilitating Definitive Diagnoses
When it comes to complicated diagnoses (such as rashes/eruptions), it’s safe to say dermatologists get out of it as much as they put into it. In cases like these, the value of the report you receive from the lab sometimes reflects the amount and quality of clinical information you share with the dermatopathologist.
For instance, including your differential diagnosis in the requisition form can help steer the dermatopathologist in the right direction. This is particularly helpful when it comes to the diagnosis of inflammatory skin diseases. The histological findings may be subtle, and comprehensive clinical information, including photos, may be needed to arrive at the most accurate diagnosis.
By providing your dermatopathologist with clinical features, you can help ensure they have the required data to make a definitive diagnosis.
Relationships of Communication
When a dermatologist receives a report that is not definitive, it could be the result of the dermatopathologist not fully understanding the clinical scenario. In these cases, the dermatologist should be proactive and communicate with the dermatopathologist, providing any additional details for a more definitive diagnosis. For example, relevant information for an eruption may include the distribution, duration, symptoms, extent, and color. The dermatopathologist should also reach out to the dermatologist for more information when needed.
Meanwhile, dermatologists who value turnaround time and accurate results should make improving the relationship with the lab a priority. A survey of dermatopathologists showed that diagnoses were delayed due to lack of clinical information, as 45 percent of respondents spend more than 30 minutes a day tracking down clinical information that was not present on the order form. By voluntarily providing information upfront, following up as needed, and building relationships based on communication, you can help your dermatopathologist improve the quality of the lab results.
Digital tools can enhance laboratory reporting and enable clinicians to better correlate findings. For example, an EMR interface can simplify the transfer of data between your clinic and the lab. This can reduce the chances of errors by replacing handwriting and carbon copies. In clinics where handwritten requisition forms are used, digital tools provided by PathologyWatch enhance clinic flexibility by providing various reporting options.
PathologyWatch also supports clients interested in enhanced EMR reporting options. Where available, these EMR interfaces can provide the dermatopathologist with valuable clinical information, including clinical photos, visit notes, and the history of present illness to the laboratory. In addition, PathologyWatch is able to deliver results that speed up dermatologist report review and sign-off within their clinic.
By providing clinical features, taking a proactive role in communicating, and considering technology options to support your communication, you can experience better communication with your dermatopathology laboratory to produce better results.