Physicians encouraged to ‘embrace’ technology in practice management

Key takeaways:

• Shortcuts are available to streamline electronic health record inputs.
• EHRs should integrate immunotherapy modules.
• Real-time benefit checks improve the prior authorization process.

BOSTON — Physicians should make technology work for them and not be afraid of it, Priya Bansal, MD, said during her presentation on optimizing workflow at the American College of Allergy, Asthma & Immunology Annual Scientific Meeting.

“It’s here to stay. Embrace it,” said Bansal, who is a member of the faculty at the Northwestern Feinberg School of Medicine and of Healio’s Allergy/Asthma Peer Perspective Board.

Handy shortcuts

Bansal noted that although allergists have mostly migrated from paper charts to electronic health records, many of them are not using smart phrases, or pre-written text blocks that they can insert into patient notes by typing a short code.

Priya Bansal

“This is what’s going to be your key to save you countless hours on the back end,” Bansal said.

Bansal conceded that entering smart phrases or “dot phrases” into an EHR may seem like an “absolutely miserable” chore that is difficult to learn.

“I can probably teach you how to have your practice manager help you do this, or an [medical assistant] do this, or a virtual scribe do this,” she said.

Physicians should be building out their smart phrase inventory constantly, Bansal continued, such as when patients ask common questions.

“Let’s say, somebody asks me, ‘Oh, well, what air purifiers do you recommend?’ And I will write down, ‘I recommend this and this and this’ and I discuss it with them,’” she said. “I automatically copy that. It’s made as a dot phrase immediately, because some other patient is going to want to know that same question.”

Bansal emphasized that physicians should create these smart phrases in the moment as well.

Also, Bansal advised physicians to save scripts as they should be written as favorites.

“I can star all of those that are my favorites so I can find them quickly,” she said.

For example, she said, the EHR might default to one puff from an inhaler twice a day.

“But you always want it written that you want them to rinse their mouth after they use it. Save them, right?” she said. “You don’t have to type that six times over.”

Physicians should create order sets for frequently used algorithms as well, Bansal continued.

“Let’s say that I’m always managing urticaria. And with urticaria, I order four times X antihistamines,” she said. “I’ve saved the antihistamines. I’ve saved my typically ordered labs. I’ve saved my typically ordered meds. Make that into an order set so that you can easily push it into your note.”

Physicians should take inventory of what they have and what they need in their EHRs and then take steps to address those needs.

“What can I do to make it better?” she asked.

Bansal also encouraged physicians to network and share best practices with each other.

“What am I doing well, and what is somebody else doing well? And how can I implement that quickly into my practice?” she asked. “Maybe you can’t do everything, but maybe doing some of those things would be kind of nice.”

Ins and outs of EHRs

Skin testing templates are available for EHRs, Bansal said, but they should be outlined in the same order as the trays.

“Make those match,” she said. “Make your lives easier.”

The module can conduct self-counting, and codes drop straight into billing, Bansal said. Artificial intelligence can be used in the room to chart how the tests are read too.

“That is out there right now, or it’s on its way up,” she said.

Some practices use a separate EHR system for immunotherapy, which Bansal called “a lot of work.” These practices should standardize their documentation, templates and codes, she suggested, adding that practices should get a fully integrated immunotherapy module for their EHR if one is available.

“Everything should drop into your coding so that you don’t have to worry about billing,” she said.

Bansal said her transition took about 6 months as she simply entered patients into the module as they came in.

“Yes, it’s a little bit of pain and suffering for those 6 months. But now my life is so seamless and easy, and the billing is so easy,” she said. “It’s going automatically to my template.”

Immunotherapy modules need to be United States Pharmacopeia compliant, Bansal added.

“They’re going to want to know the mixers. They’re going to want to know what was there, how you mixed it, how you stored it,” she said. “My record requests are so much easier.”

Immunotherapy modules also let Bansal know which patients have missed their shots.

“You’re not going to lose revenue that way,” she said.

The EHR also can help practices manage their biologics. Bansal said the registry feature on her system allows her to track each lot number and dose, including samples and products. She also said she can track what is happening with each patient and find things quickly.

Plus, “the insurance is all in one place,” she said, and the registry tracks patients who may be eligible for research opportunities as well.

“It’s all about efficiency,” she said.

Bansal also cited EHR systems for their ability to blog and notify patients via text or email about changes in information.

Patient portals are helpful too, she continued, as they can be used to share forms and action plans with patients, schedule appointments and track lab values. Patients and physicians alike also can use portals to upload photos, videos and other documentation, which helps in disease evaluation and prior authorization.

“This is all about streamlining your conditions and making things easier,” Bansal said.

Also, Bansal said, real-time benefit checks in EHRs can save time in electronic prior authorizations, with responses often in less than an hour and sometimes in just a few minutes.

“Is that particular inhaler covered? What are the other alternatives? Sometimes it’s covered, but it’s $200, and I know the patient isn’t going to pay the $200, so at that point, I’m going to change the inhaler,” Bansal said. “I can have this conversation with the patient in real time, which is saving them time and saving us resources.”

Bansal said that the number of callbacks to her clinic has fallen exponentially.

“That real-time benefit check added on is very helpful,” she said.

Bansal also recommended prior authorization templates such as the one offered by the ACAAI.

“The College has such great resources to streamline workflow and help your prior authorizations go through easier,” she said.

Next steps

There are speed bumps as practices adopt new technologies, Bansal said.

“What do we do when we encounter a speed bump?” she asked. “Slow down before you speed up. Take the time.”

For more information:

Priya Bansal, MD, can be reached at [email protected].

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