Creating the Paperless Physician Office

Meaningful Use regulations have prompted more practices to consider going paperless. While the financial incentives are enticing, other benefits - such as increased efficiency and ease of access - are strong reasons to go paperless as well.

Here's how to make the leap to a paperless office.

Why go paperless?

There are many reasons to go paperless, but gains in efficiency and ease of use tend to top the list.

Molly Roberts, a board-certified integrative holistic physician in San Francisco, Calif., knew paperless was the way to go. "We were completely paperless from the beginning of starting the practice - both for ease of use and to protect the environment," she said. "The main advantage is [having] all the info in one place, [making] it easier to use over time and find things from the patient's past."

As office manager of DermaScan, a dermatology practice specializing in skin cancer screening and treatment in Santa Fe, N.M., Wendy Gerner says paperless has simplified day-to-day functions. "From a practice management standpoint, accessing any patient demographic info is simple [and] submitting claims is quick and flexible," she said. On the medical side, patients' charts can be accessed from nearly any location - even simultaneously if needed - and sending referrals and prescriptions electronically is relatively straightforward. Items are less likely to be lost or misplaced and a large, expensive storage area is no longer a necessity.

Futhermore, converting to paperless may very well pay for itself. "The improved documentation with electronic records has been shown to improve accurate coding and reimbursement, which can offset the initial and ongoing costs," said Michael Goldrich, a board-certified otolaryngologist located in New Brunswick, N.J.  

Converting to paperless

Creating a paperless office doesn't happen overnight. Months of careful planning and preparation are required as is ongoing monitoring and maintenance.

Roberts suggests that practices implement and customize the EHR first, then add in other supporting software like HIPAA-compliant document faxing software later. "For an EHR, create 'smart phrases' and templates for your notes and common prescriptions," said Roberts. An example of a smart phrase would be 'cold.' When the physician types this word into the EHR, all of the suggestions for dealing with a cold auto-populate on the screen.

A gradual conversion is best as it allows time for the inevitable glitches to be fully addressed. "Usually electronic prescribing is the easiest first change, followed by other orders, and then a gradual transition to the medical record," said Goldrich. "The best strategy is to initially do a small number of charts electronically to develop a personal strategy and then have a go-live date to fully transition the office."

Goldrich warns against rushing the go-live date as it can be "devastating financially." Instead, spend as much time as needed to train on the system and ensure the entire office is acclimated and comfortable. Hiring someone to convert paper charts to the new system can be a significant timesaver also, allowing practice employees more time to focus solely on a successful implementation.

Lastly, do your best to ease the transition for patients. The biggest changes for them may be completing intake forms via the patient portal or checking in for their appointment on an iPad. Roberts asks her patients to come half an hour early to their appointment. "We have a computer that is set aside for them and our assistant walks them through the intake forms," said Roberts. "This is time well spent as from that time on, they know how to use the system and have less frustration with it."

The challenges of paperless

Of course, a 100 percent paperless practice is ideal, but often unrealistic. A practice may be 'paperless,' but still find themselves shuffling papers to accomplish that goal. For example, Goldrich has found that patients who don't use the portal at home are reluctant to do so in the office as well. As a workaround, his practice uses bubble sheet intake forms for those patients instead, which are then entered into the system and shredded. 

During the learning phase, physicians and their staff may encounter initial drops in productivity. "All physicians will share that paperless is much less efficient for patient visits," Goldrich said. "The efficiency can be [realized] on the support staff side, since records can be produced immediately and [distributed] to referring physicians, patients, and legal records."

Moreover, group practices may face difficulties finding a system that accommodates everyone's needs. Regardless of practice size, Roberts recommends having the entire team - including front office staff - weigh in on the options as a way to maintain morale and prevent employee.

Despite the challenges, practices opting to go paperless now will likely be at an advantage down the road. "While it is not yet a reality, I have hope that in time there will be greater ability for practices to share patient information electronically," said Gerner. "This is very much in the best interest of patient care and offices that are already electronic will stand to benefit the most quickly when this does happen."

Steph Weber is a freelance writer hailing from the Midwest. She writes about healthcare, finance, and small business, but finds her passion for the medical field growing in sync with the ever-changing healthcare laws.