Chapter 3

1. Electronic Health Records for Allied Health Careers Cover goes here when ready Chapter 3 Electronic Health Records in the Physician Office

2. Learning Outcomes After studying this chapter, you should be able to: • List the five steps of the office visit workflow in a physician office. • Discuss the advantages of pre-visit scheduling and information collection for patients and office staff. • Describe the process of electronic check-in. • Explain how electronic health records make documenting patient exams more efficient. • Explain what occurs during patient checkout.

3. Learning Outcomes After studying this chapter, you should be able to: • Explain what two events take place during the post-visit step of the visit workflow. • Describe the advantages of computer-assisted coding. • List three decision-support tools the EHRs contain to provide patients with safe and effective health care. • List four important safety checks that an EHR’s e-prescribing feature can perform when a physician selects a new medication for a patient.

4. chronic diseases clinical guidelines computer-assisted coding decision-support tools disease management (DM) formulary point-of-care Key Terms

5. Patient Flow • progression of patients from the time they make an appointment until they leave the office after a visit. Whether paper-based or electronic health records are used, the basic steps are the same.

6. Patient Flow Steps • Step 1: Pre-Visit: Appointment Scheduling and Information Collection • Step 2: Patient Check-in and Payment Collection • Step 3: Rooming, Measuring Vital Signs, and Patient Examination and Documentation • Step 4: Patient Checkout • Step 5: Post-Visit: Coding and Billing, and Reviewing Test Results

7. Coding and Reimbursement • Documentation and coding plays a major role in whether a payer approves claims and reimburses the physician. • Computer-assisted coding uses software to facilitate claim processing.

8. Clinical Tools in the EHR • Decision-Support Tools • Tracking and Monitoring Patient Care • Screening for Illness and Disease • Identifying At-Risk Patients • Managing Patients with Chronic Diseases • Improving the Quality and Safety of Patient Care with Evidence-Based Clinical Guidelines

9. E-Prescribing • Institute of Medicine recommends the use of e-prescriptions by all providers and pharmacies by 2010. • Keeping Current with Electronic Drug Databases

10. E-Prescribing Benefits Increasing Prescription Safety • Drug-Allergy Conflict • Drug-Disease Conflict • Incorrect Dosage • Incorrect Duration • Drug-Pregnancy Conflict • Drug-Age Conflict • Drug-Gender Conflict • Drug-Drug Interactions Saving Time and Money