Ask Spine Surgeons is a weekly series of questions posed to spine surgeons around the country about clinical, business and policy issues affecting spine care. We invite all spine surgeon and specialist responses. Next week's question: How can spine surgeons meet the growing financial demands on their practices by healthcare reform legislation and regulations?

Please send responses to Laura Miller at This e-mail address is being protected from spambots. You need JavaScript enabled to view it by Thursday, Nov. 29, at 5 p.m. CST.

Hooman Melamed, MD, Orthopedic Spine Surgeon, Marina Del Rey (Calif.) Hospital: How user friendly the system is and the quality of their tech support.

Jeffrey Wang, MD, UCLA Spine Center: Integration is the key. Obviously, having electronic medical records is practical and essential in the current environment. Having a system that can integrate into large practices and amongst physicians within a health system with different specialties is very critical. Having these tie into data entry points, patient questionnaires and intake forms that collect outcomes and being able to integrate surveys or computer kiosks or tablets will be important. The critical factor is the ability to collect outcomes and ultimately improve patient care.

Trent J. Northcutt, CEO, Aurora Spine: Confidentiality and privacy. 

Cheryl Zapata, Chief Development Officer, Texas Back Institute, Plano: When setting up an EHR system, providers often know they will need to make sure they have IT infrastructure specialists and a system specialist.   However, one of the most important elements of EMR system implementation is a process specialist. Having someone who knows and understands the inner workings of the clinic and people, why certain processes are in place and which process are flexible is critical to the overall success of the project.

The processes specialist helps put workflows, while taking into considerations factors such as provider preference, the physical set up of the clinic, staffing and the patient population. The process specialist also looks at old processes and assesses whether or not those processes can be improved with the EHR system. EHR should bring efficiencies which are often missed if a complete review of current workflows is not looked at.

Ultimately, it is the job of the process specialist to make sure the workflow makes sense, the providers are comfortable with patient flow and that all staff are utilizing the EHR to make their jobs more effective and efficient, all of which ends with better patient care.  

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