EHR INSIGHTS

How does cloud computing fit into the modern aesthetic practice workflow? As a practicing plastic surgeon, I have seen the advantages of cloud-based systems in terms of flexibility, mobility, and modernity. Like many newer technologies, cloud-based tools like electronic health record (EHR) programs, along with marketing, scheduling, and other components, are increasingly mirroring the look, feel, and feature set that social computing tools offer us as consumers.

In the aesthetic space, confusion still remains (ironically) regarding what the “cloud” really is and how it fits into the office workflow. We are generally accustomed to installing software as a “product” on our computers. (You used to buy a program in a shrink-wrapped box, put installation disks in, and install the software as a locally-hosted product where the data is stored on your own machines.) Newer Internet-based technologies now allow you to receive software as a “service” (SaaS) where the program is accessed on a webpage or as an application on a mobile device, linked to a log-in that provides you access to a suite of delivered tools where the data and the program are hosted off-site. In this model, the vendor is actually “earning your business” on a constantly recurring basis, since there are few actual technical barriers to a practice switching vendors if the service no longer meets the practice's needs.

Cloud systems are a cluster of resources—hardware, software, and support—hosted and delivered from a remote location, with data warehoused outside the local user's computers. One commonly voiced concern about cloud computing is data security. EHR vendors understand and share the concern of providers that information in the medical record be secure, encrypted, available to the provider on demand and mindful of privacy regulations. In the aesthetic space this is just as important, since this is extremely sensitive personal health information. Most cloud-based systems store their data on massively scaled, redundant and hyper-secure systems (for example, Amazon Web Services), which are also used by major financial institutions and commercial vendors that also have a responsibility to safeguard client privacy.

A CLOUDY FORECAST

But how does a cloud-based EHR system fit in with my cosmetic office, you ask? There are several ways:

1. A cloud-based EHR system allows multiple staff members to access and enter data into a patient's records simultaneously, from the front desk intake, to the medical assistant in the exam room, to the physician reviewing and finalizing information during the visit or later in the day. There are usually no limits on how many “actors” in the office workflow can simultaneously update the patient's record, in contrast to many “client-server” (traditionally installed) software programs.

2. A cloud-based EHR system is positioned to interface with multiple cloud-based tools like practice management, marketing, social media, and other products, since there are shared software and data languages and the ability to pass patient information between applications. This can make it easier for your staff to keep track of the large array of information on any given patient, including how the patient was referred to your office, which procedures the patient seeks, what kinds of quotes and scheduling information were provided, and how you are going to follow-up with the patient. The degree to which these integrations exist is based on user demand, as well as business decisions for individual vendors. Some vendors may be more collaborative in this arena than others.

3. Getting updates from the cloud is much simpler than the process with more traditional software. Often, these updates are relatively “seamless,” with real-time changes to the product or simple downloads of updated apps on your mobile devices, similar to what is done for consumer apps on your iPad. In-app reminders and “invisible” updates on web browsers allow the product to be fixed, improved, and upgraded rapidly to all users without interrupting office workflows for slow installations or costly hardware changes.

4. An EHR system in the aesthetic office positions the practitioner to impress the patient as a modern, state-of-the-art provider who keeps abreast of the latest technologies. These products also typically have patient education tools like drawing boards, photo management, built-in education handouts, video embeds and other features that can enhance the cosmetic consultation experience and potentially lead to a higher “close rate.” I have experienced this personally and it is highly gratifying when patients tell me the drawings I did on their photos or anatomic atlas images helped clarify a procedure and showed them I have a good eye and an artistic hand.

5. Most EHR products now have patient portal tools to allow sharing of images, instructions and other information with the patient in a secure environment. This kind of patient engagement is a huge part of the aesthetic office doctor-patient relationship, as multiple touch-points are a major contributor to patient satisfaction and closing of the sales cycle. The more this kind of communication can occur securely and be documented within the record as part of patient engagement, the better the quality of the face-to-face encounters and the more protected the patient and provider can be.

6. The ability to move some of the intake process out of the “waiting room” and onto the patient's devices is good for business. Notice I prefer the term “reception area,” as aesthetic practices do not want to keep patients waiting, and a room for waiting is wasted medical real estate that is not being put into service of generating revenue. The more intake that occurs before the patient arrives in your reception area, the less time the patient wastes before coming back to the treatment and consultation areas, where the real care occurs and practice revenues are generated.

Indeed, there can be clarity in the cloud, if you know where to look.

Tim A. Sayed, MD, FACS is Medical Director, EMA Plastic Surgery™ and EMA Cosmetic™ at Modernizing Medicine. He is also an Executive Committee Member of HIMSS EHR Association.