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Young Ophthalmologists
Staying Ahead in the Digital Age of Medicine

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PDAs. Online forums. Google and the Academy’s new Ophthalmic New & Education (O.N.E.™) Network. As a young ophthalmologist, you’re probably already using many of these technologies and services for problem solving, communication and research. But with Medicare’s introduction next year of bonuses for physicians who e-prescribe, electronic workflows won’t be an optional part of practicing medicine much longer. Successful participation in this changing system requires both fully interoperable systems and devices in your practice and an understanding of Medicare’s new bonuses.

Your Systems and Devices, Working Together
As you contemplate purchasing decisions for information systems, including those for electronic health record (EHRs), practice management, picture archiving and communication, it is important to consider the compatibility or interoperability of these systems and devices. In other words, can these systems exchange information with each other?

If you’ve hit roadblocks trying to connect your laptop to a new printer or accessing certain e-mail accounts from your iPhone, you know how frustrating and constraining such compatibility and interoperability problems can be. If you’ve been spared such problems so far, that doesn’t mean you won’t encounter them with your practice’s equipment and software.

You might find your practice locked into one brand or company’s equipment because they can only talk with each other. Or you may have to pay additional fees to customize interfaces between different companies’ devices. If only the different device manufacturers would agree on a set of standards, this incompatibility issue would disappear, and you could select the equipment you want based on other more important considerations.

Over the past few years, the Academy has sponsored a solution to the problems of information exchange among the systems and devices in your office. A group of vendors and ophthalmologists has worked hard to develop a set of common technical specifications to allow systems to talk to each other. This has been done under the umbrella of the Integrating the Healthcare Enterprise (IHE), which has been successful in solving the real-world integration problems of radiology, cardiology, health information technology and other specialties.

If you haven’t already used or viewed IHE firsthand, the Joint Meeting is your chance. Just visit the Electronic Office, Booth 5217 in the Exhibit Hall. Check in and order a procedure to see for yourself how IHE works. You can then have an image taken (e.g, slit-lamp biomicroscopy, fundus camera, or retinal tomography) and go to a separate workstation to see your image displayed along with your registration information. Finally, a bill will be automatically generated, based on what procedure was performed. If there are any errors made in the patient name and demographics, it can be corrected on one system and passed onto all the other systems. Best of all, when you complete the brief demonstration (it should take five to 10 minutes), you can receive a 1 GB USB drive.

E-Prescribing and Other Resources
Another key component of electronic workflow in your practice is e-prescribing. E- prescribing is the automation of the prescribing process, with new prescriptions going to the pharmacy’s computer and refill requests coming to you electronically for your authorization. E-prescribing can also provide ready access to patient medication history. Your e-prescribing system can be either stand-alone or part of an EHR.

Starting with a 2 percent bonus in 2009 and 2010, Medicare will provide incentive payments for e-prescribing. In 2011 and 2012, the bonus offered will be 1 percent; it will drop to 0.5 percent in 2013. Beginning in 2012, Medicare will also start imposing reimbursement penalties for eligible professionals who are not successful e-prescribers or eligible for an exemption.

To qualify for the e-prescribing bonus, you must have a qualified system, and a minimum of 10 percent of total Medicare allowable charges must come from office visit codes (eye codes, evaluation and management or consult codes). Visit to find out if your software is certified to generate e-prescriptions that are compliant with the new Medicare regulations. You can also learn more about the features and benefits of e-prescribing.

Learn More at the Joint Meeting
For more information about electronic medical record keeping, e-prescribing, and other technology-related systems, check out the following programs at the Joint Meeting in Atlanta.

  • Introduction to E-Prescribing: Improving the Safety and Efficiency of Medication Management — FREE session outlining what e-prescribing is and how to implement it, including a discussion of available Academy e-prescribing resources. Nov. 9 from 1:15 p.m. to 1:45 p.m., Room A412.
  • Successes and Bumps Along the Road to EHR Implementation and E-Prescribing — Lessons Learned and the Need for Interoperability, a discussion at the Technology Pavilion on Nov. 9, 2:30 p.m. to 3:30 p.m., Hall B-5, Booth 5243. 
  • An AAOE course on electronic medical record adoption that will also provide information on e-prescribing on Nov. 9, 4:30 p.m. to 5:30 p.m., Room B303.
  • A symposium on physician accountability, which will cover profiling, Medicare quality reporting and related issues on Nov. 10, 12:15 p.m. to 1:45 p.m., Room A412.

For additional information about the IHE, visit For more information about the Academy’s Electronic Office or Technology Pavilion, visit our e-prescribing page.

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About the author: Flora Lum, MD, is the policy director for quality of care and knowledge base development for the Academy.