Managing Physician Queries
in the EHR
By Lou Ann Wiedemann MS, RHIA, CPEHR, FAHIMA
FEDERAL INCENTIVES PROVIDED for the meaningful use program under the American Recovery and Reinvestment Act are encouraging hospitals to adopt electronic health records (EHRs). Eighty percent of hospitals are planning to become meaningful users of EHR technologies in 2011, and the health- care industry’s movement toward EHRs is increasing the need for changes surrounding the traditional paper physician query process. 1 Now is the time for organizations, coders, and physicians to begin planning for an electronic physician query process that will merge with ongoing documentation efforts.
To begin the process of implementing electronic queries, or-
ganizations should review current policies and procedures re-
garding the query process. Questions to ask when reviewing
these processes include:
x What is the purpose of the query process?
x Where are the backlogs?
x How many query forms are used?
x Who is responsible for initiating the query, and who is re-
sponsible for follow-up?
Answering these questions will help organizations identify
points within the process where an electronic query system can
create efficiencies. For example, if a backlog is seen in query
follow-up, the organization may choose to implement a query
system that has automatic physician reminders built in, which
would reduce or eliminate the manual step of calling physicians
and asking them to come to the HIM department to answer or
sign a query.
Communication is a key factor in the success of any query process, and electronic queries are a perfect way for organizations
to increase communication and decrease down time. Streamlining the query process by implementing electronic queries enables both coders and physicians to decrease the time spent answering questions and playing telephone tag with one another.
In order to select the correct electronic query system, organizations should spend time identifying what they want from an
electronic query process prior to submitting a request for proposal. Providing vendors with a detailed list of product expectations will help the organization find the right match.
Organizations can approach electronic query system implementations as they would other EHR module implementations.
They should name a project lead, establish a detailed schedule,
and identify pre- and post-metrics for measuring success.
The project lead should become familiar with the system and
how it works. For example, if the system includes automatic e-mails to physicians for query completion, the lead should determine how physician e-mail addresses are maintained. In addition, many system security initiatives do not allow protected
health information to be sent via e-mail unless the information
is encrypted. The lead should determine if the vendor or EHR
system has the functional capability to encrypt the queries.
Other implementation considerations include the number
of licenses the organization will require for the software, how
the vendor and the organization will manage version updates,
and how queries will be attached within the EHR. Organizations
should make sure they purchase a sufficient number of licenses
to enable coders, physicians, and managers to access the system