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A Need for EMR Templates in Orthopedics: Q&A With Dr. Ira Kirschenbaum

Health Information Technology

As physicians across the nation are quickly learning, adopting electronic medical records is far more complicated than just deciding whether to buy an Epic or Cerner system.
Once an EMR system has been purchased, physicians need to learn how to use them. And given that reimbursement is dependent on proper documentation and coding through EMRs, it is essential that physicians learn how to use them quickly and effectively.

Soon after his practice, Kirschenbaum Orthopaedics in White Plains, N.Y., made the switch to EMRs, Ira H. Kirschenbaum, MD, discovered that EMRs are like blank books that need to be filled in. Dr. Kirschenbaum, who is the chairman of orthopedics at Bronx-Lebanon Hospital Center in New York, began creating templates to help him input notes into his EMR. He recently put the templates together and published "The OMG EMR Template Book-Orthopaedics." (DTC Healthcom, 2013).

Here Dr. Kirschenbaum discusses the book, the importance of EMR templates and why non-orthopedic surgeons should think about getting a copy.

Question: What inspired you to write this book?

Dr. Kirschenbaum: I wrote the book because, well, first of all I have been involved in electronic media for two decades. And in 2000, my practice switched to electronic medical records and I started realizing that it is about the pieces of content that go into the EMR and not the program itself that is important. I started developing my own templates and people started asking for them. So many people were asking for them and EMRs are getting so much more traction now, so I put my templates together. It is nearly a decade of work put together. I also wrote the book because I felt that people really needed a jumpstart in terms of developing notes. When you buy an EMR, it rarely comes with any directions on how to start putting in notes electronically. Also the templates I created are vendor-neutral, so they help providers begin putting in notes electronically. It really is a great jumpstart to have templates of notes as an example.

Q: What do you think will be the biggest takeaway from your book for readers?

IK: One of the biggest takeaways will be that templates in EMRs is a very large world. There isn't just one template for one note. [Readers] will see a wealth of EMR templates in the book. This book will also help readers in deploying and adopting their own EMR, especially since deploying your EMR is often a very big time commitment. It's sort of like how buying a set of golf clubs doesn't necessarily mean you know how to use them already. Adopting an EMR is like that. It's like buying golf clubs when you still need to learn how to play. This is the book to help you deploy your golf clubs. This is the book that helps you learn how to use your EMR and actually gives you material to populate it.

Q: What was the most challenging aspect of writing this book and designing the templates?

IK: Whenever you do something for yourself, it always makes sense. But when you have to explain it for someone else - that's when it gets difficult. The challenging aspect was taking something that was second nature to me and making it accessible to other people. I had to make sure that the templates had a logic to them, which would make sense to someone else using the book. I had to make sure the templates were readily accessible. I had a number of people read through them and make sure they were accessible.

Q: Of the templates in this book, which, in your opinion, will be the most useful for orthopedists?

IK: Probably the ones that are connected to different levels of coding. Many of the templates are designed with coding compliance in mind, and because many physicians want that, this will be the most valuable for them. Physicians want to be able to match their templates to codes easily because you get paid according to the codes. The book is not a coding book but shows different levels of coding, which is valuable to physicians as they start coding. Ultimately, improved documentation means improved reimbursement.

Q: Do you think all specialties should have specifically designed EHR templates? Or was there a particular need for orthopedists?

IK: There is no question in my mind that every specialty needs a book like this. This is not the final word on EMR templates, but it's a start.

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