You May Save FTE Time by Switching to an EMR Interface

By April Larson

In an increasingly digital world, where digital devices make us more efficient (except for time spent playing Candy Crush), we often find that digital healthcare solutions cost us time and efficiency. While we anticipate technology will improve efficiencies, we often find we are trading one inefficiency for another. Why does my iPhone seem to solve my every problem (“Hey Siri, where is the closest gas station?”), yet I’m still spending my evenings feeding my kids Top Ramen while I catch up on my clinic notes? Ironically, in the increasingly sophisticated digital age, healthcare technology feels outdated and less robust than we experience in competitive arenas like entertainment or business.

In this article, we will discuss ways to save FTE time and simplify clinic workloads by examining some of the obstacles created by new technology, defining what an HL7 interface offers, looking at the challenges of paper, and digging into the advantages of digital pathology. 

What are the technological challenges?

  1. There is no universally accepted electronic medical record.
    One challenge with information sharing in healthcare is that there are many universally accepted electronic medical record systems. In fact, over 130 vendors produce EMR systems. Therefore, while healthcare is becoming increasingly digital, many of us are still disconnected and cannot share medical information—such as clinic notes, lab results, and pathology reports—as seamlessly as we would like. Dermatologists and staff spend lots of time tracking down reports and medical records, sending consult letters, or performing other necessary communication to provide the continuity of care patients need.
  2. Regulations can complicate the sharing of medical information.
    This is a crucial reason why the medical world is one of the few industries where old-school faxing is still widely embraced. Digital communications are complex and sometimes may not be compliant with HIPAA or HITECH requirements.
  3. Electronic documentation is often less specific.
    It can be beneficial to use templated descriptions for common diagnoses. However, when I biopsy a lesion, a more specific description is preferred. Manual entry of a lesion description can be cumbersome, especially when training a new medical assistant; either I accept a less detailed description or differential, which can limit the amount of information getting to my pathologist, or I spend my evening catching up on my notes rather than binge-watching Schitt’s Creek.

As digital technology makes its way into healthcare, perhaps Siri will one day be able to scribe and bill all my notes while my medical assistant and I happily engage with and educate our patients. In the meantime, the most exciting way to start sharing electronic information is through an HL7 interface. 

What is an HL7 interface?

HL7 stands for Health Level Seven, which refers to set standards for transferring healthcare data between healthcare providers. With a membership that includes 90 percent of healthcare system vendors, the organization establishes specifications to safely and accurately exchange sensitive healthcare data.

How do I get the LIS and EMR talking?

Laboratories, including dermatopathology laboratories, use an electronic system called the LIS (laboratory information system). The dermatopathology world’s EMA and EZDerms include an LIS such as PowerPath, Beaker, or WebPathLab.

While these systems are not designed to talk to your EMR, the HL7 interface enables EMRs and LIS programs to communicate the same language. This allows for the transfer of data between otherwise incompatible electronic medical records.

Why do I want an HL7 interface?

While 60 percent of clinics already have implemented EMRs in their practice, most have not experienced the game-changing capabilities that an interface provides. The exchange of information through this interface can simplify your daily workflow considerably. By way of an HL7 interface, the lab can send reports electronically directly to your patient chart and, in certain instances, populate the diagnosis and treatment, streamlining your review and signoff.

The adoption of technology can save the staff from menial, time-consuming tasks and allow them to participate more in patient care, which increases both staff and patient satisfaction.

What are the challenges of paper?

When a dermatology practice sees 40–50 patients per day, relying on paper to manage the workflow can create inefficiencies and impact the time to deliver results to patients. Consider the following weaknesses:

  1. Handwritten requisitions and labels take a lot of time, are redundant, and can be difficult to read.
    Pertinent information must be recorded both on the requisition and the label. Handwritten forms not only take time in the clinic, but labs must also use manual entry. When the dermatopathology lab receives the requisition, the lab tech must manually enter the requisition information into the LIS and match it to the biopsy. This process is prone to human error.
  2. Reports must be faxed and scanned.
    The dermatopathologist signs an electronic report, which is often faxed and then scanned into the dermatologist’s EMR. Papers also occasionally get lost or misplaced in a busy clinic.

What are the benefits of a digital pathology workflow?

To move beyond the challenges of paper, dermatopathology lab services like PathlogyWatch can build an HL7 interface directly to the dermatology clinic’s EMR to optimize margins of error and turnaround times, preserving precious staff and provider time.

  1. There are fewer redundancies and room for mistakes with electronic requisitions and labels.
    When you document a lesion in the electronic chart, you can use this description and diagnosis to generate electronic requisitions and labels rather than write down the same information in multiple places, like the location or date of birth. Patient information is also easier to read, more accurate, and simple to double-check with the patient.
  2. Reports automatically upload to the patient’s chart.
    When dermatopathology reports are signed out, the reports are uploaded directly into the patient’s EMR.
  3. Automatic data entry is also possible.
    In some instances, the diagnosis and treatment options autopopulate for the dermatologist’s quick review and signoff.
  4. A digital pathology log can be easily shared amongst providers and staff.
    Providers can quickly sign off on a report, and a reminder is automatically sent to the electronic pathology log, where multiple staff members can work simultaneously.

The pressure is on dermatopathology laboratories to simplify the way information is shared with their partner dermatology clinics while maintaining compliance. By assuming the many time-consuming, routine tasks involved in a traditional dermatopathology workflow, a secure and compliant HL7 interface allows both dermatologists and their support staff to spend more time in patient care areas that are more rewarding, such as patient interactions and education. We win by spending our time doing what we’re best at and most enjoy: seeing patients. 

And who knows? Maybe we’ll have time to get in an episode or two of that show we’re behind on.