Case Study-Migrating from Paper to Electronic Charting in the ED

Posted on Fri, Jan 31, 2014

Three MEDITECH 6.0 Hospitals Transition to FlexChart™ Physician Documentation

ED physician documentation tools are frequently included in the EDIS/EMRs selected by hospitals from their enterprise vendor with little consultation from care providers.  This often leads to low provider adoption, reduced productivity and impaired patient flow all caused by the implementation of systems that were designed without sufficient ED clinical user focus.  Rigid documentation tools within EDIS vendor applications often fail to meet the challenges of the dynamic ED environment such as meeting the constantly evolving performance markers set by CMS and insurers and ED resource management.  As a consequence, it is very common that ED physicians fight to retain their existing documentation tools (paper chief complaint forms or dictation with transcription) and resist changeover to EDIS-electronic charting while accepting other elements such as CPOE and electronic nurse documentation.  Hospitals often find themselves frustrated by having to trade-off the goal of having ED doctors  capture chart data electronically with the increased costs and lower staff and patient satisfaction that a result from implementation of dysfunctional EDIS products.

A Solution That Works for All:  FlexChart™

Forerun’s FlexChart™ is frequently selected as an elegant compromise between the hospital executives and the ED physicians group.  FlexChart™ is an advanced charting and care management solution that integrates with and enhances single vendor EDIS thereby delivering to the hospital, an integrated electronic charting solution, and to the ED physicians, an advanced charting and care management solution that leverage-in place workflows and technologies and that address the shortcomings and productivity gaps created by use of single vendor solutions in the ED. 

Three East Coast Hospital Success Stories

Three eastern seaboard hospitals recently elected to implement FlexChart™ Physician Charting on top of the MEDITECH 6.0 applications in use in their Emergency Departments.  These ED’s desired to move from documenting on paper to electronic documentation but were concerned about a loss in productivity that would result from use of the charting module offered by their in place EDIS.  FlexChart™ integrates with and augments MEDITECH EDM, and other single vendor EDIS, to improve workflow through faster charting and by presenting key data to enable physicians to make faster, more informed decisions.

Forerun’s specialized implementation team for MEDITECH sites helped these customers define their workflows in relation to existing MEDITECH EDM workflows and worked with the sites to implement the FlexChart™ Physician Charting solution in about 90 days. 

Read about the benefits of the successful implementations of FlexChart™ at these sites below. 

Fast & Complete Charting

FlexChart’s™ electronic documentation tool combines the speed of the paper chief complaint forms and the richness of dictation.  “Electronically checking boxes coupled with the added flexibility of being able to dictate using voice recognition for the medical history and medical decision-making is the best of both worlds, “ said the Chief of the ED at one of the newly implemented sites.  “This process not only creates a chart that is optimal for billing and risk management, but is also a great clinician-to-clinician communication tool,” he continued.  The data rich nature of FlexChart™ coupled with its speed and ease of use creates a competitive advantage allowing physicians more time at the bedside and smoother patient flow while improving coding efficacy, payer reimbursement, and data collection and management.

Improved Quality & Patient Care

FlexChart™ incorporates electronic quality improvement and core competency functionality that allows for the tracking of adverse events and errors by physicians as well as measures quality of documentation, clinical judgment, and resource utilization.  Functionality including problem flagging, individual provider preference notification, clinical alerts, and individual care plans allow the emergency physicians to tailor care to the needs of the patient, the individual referring physician and to hospital CMO policies.  These features drive dynamic quality improvement beyond the capacity of most emergency departments. 

Coding Capture for Billing

“FlexChart™ delivers chart output that leads to specific improvements in coding capture for both technical and professional billing, especially in the subjective arena of the table of risk and medical intensity of service assessment critical in achieving the higher Evaluation & Management codes,” said a Medical Director at another of the sites.  

Forerun has collaborated with ED physicians’ billing companies to package and electronically transfer patient visit information from the ED to the billing company to reduce the efforts required of hospital staff and to improve the completeness of what is processed by the billing company (driving improved billing results).  Working with the billing companies, Forerun modified FlexChart™ to incorporate certain elements, such as various attestations, to improve the documented evidence of actual care provided and better justify the bills created and sent to payers. 

Improving Continuity of Care:  Interoperability with Non-ED Care Providers

“FlexChart™ also improves the speed and quality of communications with hospitalist and referring physicians.    The ability of primary care physicians to easily enter information when referring a patient ensures timely communication of important care considerations,” continued the Medical Director.  The FlexChart™ clinical viewer is available to authorized users outside the ED and complete visit summaries are sent to PCP’s and specialist after patient’s ED visit.  Clinical alerts, individual care plans, as well as provider preferences allow the emergency physicians to fit the care and communication to the needs of the patients and individual referring physicians.

FlexChart™ has built-in connectivity with specific PCPs and specialist networks to exchange patient information with providers outside the hospital involved in the patients’ care.

  • Embedded  PCP referrals and notes
  • Link to primary care patient records
  • PCP /specialist access to ED visit report
  • Auto transfer of ED chart back to PCP / Specialist
  • Integration of consultants’ workflow into the ED workflow – integration of offsite radiology services, for example.
  • Integration helps grow market share via improved patient and provider satisfaction

Analytics: Driving Better Care & Operational Performance

FlexChart™ collects and reports on key quality measures and performance metrics in close to real time.  Advanced analytics and drill down capabilities provide ED Directors the tools needed to affect ED physician behavior change required to meet targeted operational and patient treatment goals.  FlexChart’s sophisticated analytics platform promotes “smarter care” – driving consistent care delivery, greater throughput and better utilization of resource within the ED.

Technology Enabler: SaaS Delivery

Forerun’s SaaS based model allows for rapid system implementation and swift modification of the software to meet the changing demands of customers.  Clinical content within FlexChart™ is always current ensuring ongoing compliance with regulators.  Software upgrades and enhancements are made on an ongoing basis; there are no patches or downtimes for system upgrades and customer specific enhancements can be made as requested – there is never a wait for a “new release”.  Forerun’s flexible system architecture and “light footprint” model permits rapid deployment of embedded third party technologies and new hardware solutions, reduces the utilization of scare hospital IT resources and leverages centralized system expertise.  FlexChart™ is 2014 Certified as a Modular Hospital EHR by the Certification Commission for Health Information Technology (CCHIT®) supporting client hospitals’ efforts to obtain incentive payments under the American Recovery and Reinvestment Act (ARRA) for the Stage 1 and 2 Meaningful Use of certified health information technology.



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