Moving EHR beyond the clinical practice

Implementing electronic health records into an ambulatory surgery center fosters efficiency and increases patient and staff satisfaction.


Take home message: Implementing electronic health records into an ambulatory surgery center fosters efficiency and increases patient and staff satisfaction.


By William Watson and Lizbeth Alicea

Modern health-care facilities like ambulatory surgery centers (ASCs) are a primary source for surgical procedures by providing same-day care. Prior to the advent of ASCs, surgery was performed in hospitals and required that patients waited weeks for an appointment and spent days in the hospital.

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As a result, electronic health record (EHR) vendors are beginning to cater to the unique needs of ASCs with the advent of software that increases efficiency, quality of care, and profits. Tomoka Eye Associates recently incorporated an EHR that is ideally suited for an ASC environment. Some of the lessons learned are shared in this article.

Increase efficiency

According to the American Society of Ophthalmic Administrators’ technician benchmarking study (, EHR increases efficiency. In the operating room, surgeons are able to chart quickly, as well as capture images from surgical monitors during the procedure, integrating all components into the patient’s file.

Compartmentalizing communication between staff and employees also plays a role in increasing efficiency.

For example, users can access test results through an EHR chart, rather than relying on a staff member to make a physical transfer of a paper chart to the surgery center for the day, then retrieve the record and file it back with the clinic.

As a result, more than one person can read an electronic chart at the same time. All data are stored in one place, which makes access easier logistically compared with paper.

Next: Mitigate risks


EHR for ASCs not only eliminates the need for paper charts and streamlines workflow, but it also lowers the risk of errors by standardizing processes.

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For example, it ensures that a patient’s record is complete and has undergone proper review by the necessary physicians prior to the patient’s discharge. EHR in an ASC also mitigates risks by reducing legal exposure and improving compliance with the Health Insurance Portability and Accountability Act.

Staff can easily access any data requested during accreditation or surveys by Centers for Medicare and Medicaid Services, as well as provide documented proof for compliance issues when needed.

Additionally, it is possible to incorporate a mobile computer that can travel from bedside to bedside to ensure privacy for each patient-although extreme care is still given to what information is displayed on the screen when patients are present.

Next: Patient, physician satisfaction


In the combined practice-ASC, both physicians and staff have experienced increased satisfaction with use of an EHR.

For example, physicians can access patient records from any location in real time, which eliminates the need for them to travel to the ASC to fill a prescription or to carry files home in order to manage a patient remotely.

EHR in an ASC also reduce costs associated with paper-related administrative duties, such as buying paper, printing copies, and storing and retrieving paper charts.

However, this also translates into reallocating staff responsibilities that are spent on time-consuming tasks associated with managing paper charts. Physician and staff reap the benefits of spending time on more rewarding tasks.

Next: Incorporate an EHR into an ASC


Streamlining an EHR from a clinic to an ASC allows data to become easily available on both ends with less room for error or lost data. When the decision was made to implement EHR into the ASC, Management Plus’ eye-care-specific EHR had already been implemented into the clinic. Therefore, there was complete comfort with the software.

Prior to purchasing the EHR, peers who were utilizing the software were shadowed to witness how the vendor engaged with its clients as partners. It was kept in mind that the purchase also included the people behind the company, because it is a given that software is often in a constant state of change.

Management Plus worked alongside as a partner to help create an ASC-EHR that now serves as a model for the vendor. Involvement at this level was an important component for successful implementation. Because there was no time frame mandated by meeting meaningful use requirements, the practice was able to take the time to customize the software with the EHR specialist.

In addition, weekly meetings were held with the nurse and business managers from the ASC to customize every template to fit the needs of the ASC.

Clinics that have already invested in EHR will find that transition to an ASC will benefit both the clinic and the ASC, alike, and will continue to foster efficiency and increase patient and staff satisfaction.

Fortunately, there is EHR software designed to fit the unique needs of many types of ophthalmic specialties and health-care organizations. EHR software designed specifically for ASCs can conform to the needs of an ASC without adding complexity to its protocols.

Next: Tips for implementation


Tips for ASC-EHR Implementation

·      Select a vendor that provides exceptional support and whose representatives are reliable and accessible.

·      Select an ASC-EHR template that is easily customizable.

·      Take time. There are no meaningful use requirements to meet for ASCs.

·      Strategically select key individuals for the install team. A nurse manager, business manager, and IT specialist are ideal. Keep the group small to streamline the decision-making and implementation processes.

·      Train the physicians first as champions of the system. Ensure that physicians do not speak negatively about the system in front of staff.



William L. Watson is chief executive officer, Tomoka Eye Associates, Ormond Beach, FL. He may be reached at 386/672-4448 or

Lizbeth Alicea is IT Manager, Tomoka Eye Associates, Ormond Beach, FL. She may be reached at 386/672-4244 or