| |MARCH 202091) Complaints2) Patient and family history3) Diagnosis4) Investigations 5) Medicines6) Surgery / Procedure7) Admission advise8) Follow upOut of these eight, there is at least five sections which are revenue generating sources for a hospital. Whenever a clinician prescribes medicines, advices investigations, procedures, surgery or admission or orders a follow up to a patient, these become business opportunities for the hospital. From now on we shall refer to these as Revenue Opportunities (ROs) or leads.An EMR alone gives the opportunity to create these as leads which a paper or manual EMR does not provide. A lead is generated at the very moment a clinician enters any of the ROs. A small team can be formed which shall pursue these leads. This teams shall now be referred to as a lead teams. There can be a single team to handle all such leads or separate for investigations, admissions and surgeries. A run time notification in the form of an SMS and/or an email gets shot to the lead team members. They shall follow up with the patients and convert them for majorly the following:1) Investigations of more than Rs. 1,000 (this value can be different for different hospitals) in total value. These can be simple pathology investigations or diagnostic investigations like MRI and CT.2) Advise for surgery or some procedure.3) Advise for admission for medical management etc.4) Prescription for medicine of more than a total value of Rs. 1000 (This value can be different for different hospitals).5) Follow up in the OPD in cases of ongoing treatment of chronic illnesses like CKD, IBD, observation courses like obstetrics (pregnancy cycle), immunizations cycles, etc.Although lead types 1 and 4 as mentioned above are low ticket leads, but, these eventually have the potential to get converted into lead types 2 or 3 which are high value ticket size leads. Lead type 5 is a whole new concept. Here, the patients who have the need for longer duration treatments are taken care of. These patients have cyclic visits to the hospital like dialysis or a pregnancy cycle of an expecting mother. When the doctor marks the follow up date for such patients, the system sends out another lead to the lead team. Lead team can also follow up with the patient to make sure that the continuity of care is not lost. This is an important area which needs attention as sometimes, chronic disease patients tend to discontinue their treatment or simply continue their treatment at another hospital. This mechanism can help plug these kind of leaks through the use of such technology platforms. The system can also send out reminders to patients one day prior to the appointment date. EMR has been more than often been seen as something to benefit in the longevity of records and clarity of prescriptions. Whereas, today we see EMR as something that can add the assurance of continuity of care, jump up revenues, and save the patients from prescription errors as well. Certain CDSS (Clinical Decision Support Systems) are available in the international as well as domestic Indian markets. These have to be integrated with the EMR. The CDSS keeps a watch on the prescription of medicines in both OPD and IPD. The CDSS gives out alerts whenever a doctor wrongly puts a dose for a medicine, when a medicine being prescribed interacts with another on-going medicine, when a medicine being prescribed is believed to interact with a current allergy, when a medicine should not be prescribed to a pregnant women or a lactating mother and also when there is a duplicate medicine being prescribed.Such alerts save both the patient and the doctor from prescription errors. It is very much obvious to conclude that the EMR today is a lot more valuable than it was perceived to be in the former years. Given these benefits, clinicians today are much more open to EMR. Ashish Sood
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