Pediatric Informatics: Computer Applications in Child Health (Health ...

16 Prioritizing Pediatric Investment for IT in Smaller Practices 223
Increasing efficiency through reduced paperwork and physical storage
Providing reminders, alerts, and other decision support
Reusing practice data for research and to understand and plan practice
16.3.1.1 Optimizing Charge Capture
Electronic health record tools and other tools can help improve the accuracy of coding,
resulting in higher levels of reimbursement. 7 Coding tools can analyze documentation
levels to suggest appropriate billing levels for the provided care and what is needed to
optimize appropriate charges. The educational and remuneration value of such tools
to a practitioner can be significant 8 and are a principal selling point for EHRs.
16.3.1.2 Assuring Complete Documentation
Improved charge capture depends on improved documentation. Handheld and
mobile technology can streamline necessary documentation of clinical procedures
and informed consent. Such tools can also accurately record time for encounters,
such as behavioral counseling or complex disorder evaluations, which may be
billed according to clinician time spent.
Documentation of encounters or consultations narratives is performed by transcription
of dictation or use of template reports. Speech recognition technology,
which has widespread use in radiology, is not used extensively in primary care, but
the availability of low cost computer memory has made facilitated recording for
transcription (leaving a copy of un-transcribed reports available). Templated reports,
filled with data directly from an EHR database, may be created with standard word
processor and spreadsheet merging tools to facilitate form completion. However, the
majority of reports are still prepared by handwriting, typing, or word-processor.
16.3.1.3 Increasing Efficiency
Practice management systems can be used to retrieve and validate demographic and
insurance information and update patient information as needed when telephone or
patient portal requests are received. Other functions, such as medication reconciliation
may also be performed easily.
Electronic prescribing (eRx, Chapter 19) and computerized prescription writers
can improve the quality and safety of delivering drugs to patients. In both of these,
electronic prescription template forms connect EHR problem, allergy, and medication
lists and formularies to prevent illegibility, dosing errors, allergy identification, and
drug interactions. More efficiency and checking can be added when eRx applications
connect office to pharmacy, linking knowledge from both sides.
Other advantages of digital information include reduction or elimination of
paper, resulting in more efficient use of office space. This benefit must be weighed
against the costs of converting legacy documents and creating redundant access.