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Q&A with Daren Smith

Achieving ASC Accreditation Success With Your EHR-1Daren Smith, vice president of ASC Solutions, recently hosted a webinar on "Achieving CMS and Accreditation Success: The Role Your EHR Should Play," where he provided insight and guidance concerning Centers for Medicare & Medicaid Services (CMS) and accreditation surveys and the value of ASC software. The audience was highly engaged and asked great questions during the Q&A portion of the program that provided additional opportunities for Daren to explore how an electronic health record (EHR) system helps ambulatory surgery centers achieve successful CMS and accreditation surveys.

Below are the highlights of those questions and responses provided by Daren, edited for readability. To view the webinar on-demand, please visit the SIS Resource Library.


Q: For ASCs that you've seen effectively use their EHR to help with accreditation, what have they done particularly well?

A: These surgery centers have used all the capabilities that their EHR has to offer. They've designed their questions the software prompts them to answer so that they are efficient and meet the standards. They've used the language right out of their accreditation manual for the way they present consents.

It's really about building the system in conjunction with the standards and using all the features and functionality to support accreditation efforts. Just because you get tired of the popup that says "the patient's St John's wort reacts with the morphine" doesn't mean you should shut off the warnings for everyone.

Those that have used their EHR the most effectively have used the system in whole, not parts and pieces or shutting things off.


Q: We're going live on our first EHR soon. Is there a particular area or areas you suggest we focus on first to help everyone here get comfortable with the new system and processes?

A: The ones I've seen be most successful with this: If you've gone through an accreditation survey before on paper, make sure your EHR is matching that paper process. Ask the questions in the exact same way in the exact same order. That's not going to create additional work for you. Rather, it's going to give you that peace of mind and your nurses the peace of mind that you're not changing their processes. You're just asking them to put information in a different place. Instead of putting the answer on a piece of paper, they're putting it into a computer. When they put it into a computer, they're going to have the peace of mind that if they did accidentally forget something or chart something incorrectly, the system is going to flag it for them. That's probably the best piece of advice I can give for ASCs moving from paper to an EHR.


Q: How can we most effectively use our EHR for quality assurance and performance improvement (QAPI)?

A: The magic question. This is a big motivator for moving to an EHR and a game-changer for anyone who runs their quality improvement (QI) program.

Let me tell you what a quality study looked like when I was working in an ASC and needing to do one on paper. Let's say we wanted to take a look at how many of a doctor's patients complained of pain over a certain level after discharge. That meant I was pulling 100 paper charts, sitting down with a team of people, and we were looking at post-discharge questionnaires to see how many of the doctor's patients answered "yes" to the question about experiencing pain over a certain level. It could take hours to do that work, and it was a lot of expensive work.

If I'm using an EHR, that's a report I can run. I can just look in my reports module and run a report that says, "Show me everybody who meets this criterion." When you're using a discrete data system, like most EHRs, that means the data you're entering is not only searchable but it's reportable. This makes chart audits a lot easier. It is going to make that searching and reporting for studies you're doing a lot easier as well.

When you're able to achieve that standardization and have that monitoring effect of an EHR, you can actually do meaningful work through your quality program instead of choosing the easiest QAPI study option.