Q: What are the best practices in using EHR?

A: Based on my experience in working alongside fellow O.D.s and thousands of optometric practices on their technologies, software solutions and needs, I offer these five tips for optimal EHR utilization:


It is imperative that optometrists and their staffs know all the existing functionality of their EHR software, as there may be shortcuts, such as built-in and updated contact lens parameters for specific contact lens brands, that can make using the EHR easier. O.D.s and their staffs should take the training period during software implementation seriously and take advantage of all the available related resources. It’s helpful if the system, such as a cloud-based EHR, has an online knowledge base that the optometrist and staff can refer to at any point when additional questions regarding functionality or onboarding new staff arise. Keep in mind that most vendors have pre-recorded training modules, so O.D.s and their staffs can accomplish this learning efficiently.

In regard to practices that host software on their own servers, a shortcut could be entering the high and low prescription to see a contact lens’ available powers at a quick glance. For example, for a toric contact lens, the staff member could enter the high and low prescription for each astigmatic option, such as +6.00 D to -10.00 D for -0.75 cyl and so on.


Over the years, I’ve learned that while many optometrists love the idea of customizable software, most don’t take the time to actually do it. Hence, I often see O.D.s consuming valuable patient-doctor time adding tests or documenting notes in their charts when these items could have already been a part of their EHR exam template.

I recommend creating custom templates for the most common appointment types and procedures to save the optometrist time with each patient in the exam lane, allowing time for patient education and the reduction of overall data entry-induced frustrations for doctors. When creating custom exam templates, optometrists should consider preloading their screening procedures and any other tests they may perform (e.g. macular pigment testing, meibomian gland imaging, wellness screening tests, etc.) with any correct CPT codes associated with each. Having the correct CPT codes associated with these templates will decrease coding errors and get reimbursements paid out quickly. Additionally, documentation for this disease can be selected as a paragraph instead of being re-entered manually by letter each and every time.


Piggybacking on tip No. 2, some EHRs link the correct CPT codes to the correct ICD-10 codes automatically, so the O.D. isn’t spending valuable patient-doctor time in the exam lane documenting these items. Also, intuitive software allows for accurate coding, resulting in lower denials from health insurance companies.

A caveat: Regardless of this functionality, optometrists and their staffs should always double check all the codes produced by the EHR to ensure primary ICD-10 codes match the primary chief complaint and reason for the visit in the exam note. The onus is on the practice to “get it right.”

Secure messaging is an often underutilized feature in EHR systems.
Sergey Ilin/


Some EHR vendors update their software with workflow enhancements or new features that can improve efficiency. Vendors call these “software releases.” In my experience, staffs often don’t pay attention to these releases, as they aren’t always obvious, unless staff read the details provided in them.

Inadvertently skipping these software releases leaves practices feeling as if their EHR is stagnant (it isn’t going to improve) or the vendor isn’t listening to their suggestions for software improvement. As a result, optometrists should make sure their staffs are identifying and reading software release notes.


I have seen practices communicating and sending protected health information items via their company email, which is neither secure nor HIPAA-compliant. HIPAA violation fines range from $500 to millions and, in extreme cases, can lead to criminal charges. (See violations at .)

One of the best breakthroughs and most under-utilized features in EHRs, in my opinion, is secure messaging. It is essentially a HIPAA-compliant emailing system that EHRs offer so practices can message patients and other providers without the concern of a HIPAA violation. This functionality offers O.D.s, other providers and patients the ability to send messages and attach files (e.g. exam notes, images, test results) with ease. Many progressive practices use secure messaging to send referrals to their local hospitals, primary care physicians and endocrinologists for mutual diabetic patients.

Most advanced EHRs offer secure messaging for patients through their patient portal, allowing patients a quick, online channel to communicate securely with their optometry practice. Optometrists and their staffs can then safely send a patient’s prescription or exam notes in a HIPAA-compliant manner. OM