Add-on Apps Can Supercharge Your Orthopedic EHR

Ira H. Kirschenbaum, MD


April 02, 2014

In This Article

EHR Shortcomings That Apps Can Help Address

How can third-party apps improve process management in orthopedics?

An app can be used to align the right patient with the right doctor at the right time. An app can let referral doctors -- say, your most-valued joint referrers -- double-book their patients directly into your schedule. Not only can it help you schedule patients, but it also can capture who the referring doctors are. You may have no slots free for regular patients for the next 2 months, but when a special referral doctor needs to fit a patient in, you want to be accommodating. Many EHRs lack this functionality, but an app can add it.

An app can help with mobile encounter capture and tracking of surgical procedures. At many hospitals, data from patient encounters seen in the ED or on the inpatient floor are captured on paper and then transferred to a spreadsheet or database program. In the process, however, patient information for evaluation and management code capture, procedures, and discharges is often lost and can't be shared with the many people in the department who need to see it.

A mobile-ED-and-floor-capture app can help. Each time a patient is seen, the first responder enters the information into the app. Then everyone is able to connect to that information via the cloud, so that every caregiver in the process knows what is going on in real time.

In addition, when a patient is discharged from active consult care, that patient's information is never lost. It is stored in the app's database for retrieval by clinicians, managers, and billers.

An app can help you track the surgical process from indication through recovery. By simply relying on our EHR, for example, we found that, depending on the surgeon, 25%-75% of all patients who were indicated for surgery did not get their surgery! There were a number of reasons for this, but threading through them was a common theme: failure to monitor and track the process.

There are now apps to automate the job. Instead of filling out a surgical indication sheet in the exam room, the surgeon opens a simple online form that begins the tracking process. The surgical bookers get these forms immediately, and all of the key steps are tracked. These apps work with standard Web browsers. The one we used helped us bring our average loss rate down to 18%.

An app can expand an EHR's often meager template library. EHRs may have a limited number of templates for building notes, for example, and the templates may not be specialty-specific. Yet third-party apps may offer hundreds of templates specifically for orthopedics and many other specialties to make EHR use more efficient. An extension of this concept is a dedicated note-maker app that makes it easy to generate the note portion of an encounter and integrate it into the EHRs of many vendors.

A large and growing number of apps that add capabilities that many EHRs lack are appearing online. Some are available in the iTunes store or other apps store. Others are available directly from the vendor's Website. If you can't find the app you want, easy-to-use app development software lets you custom-design an app for your specific needs.

But first understand the various processes in the way that you deliver medical and surgical care. Once problems are identified, you can develop or find app solutions that can add immeasurably to the functionality and ease of use of your current EHR.


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