IO Practiceware Software Blog

Our Family, IO Practiceware Customer Map

Posted by Jaime Davis

May 18, 2015 11:07:00 AM

From way up in Alaska, back down to the small town in Indiana, and across the Gulf of Mexico in Puerto Rico, we love our customers! 




We value and appreciate every one of you for being a part of our team as we grow, develop and continue to conquer. 

So, thanks, for being a part of our family. 

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Topics: Customers


Posted by Jaime Davis

Apr 20, 2015 4:40:00 PM

Your eyes are one of your bodies most important organs. They play a role not only in your personal life but also to the human body. 80% of what we perceive comes through sight! Here are a few easy steps that will help you take care of these tiny, precious, and super important, organs! 

1. Wear your sunglasses

Top Gun Sunglasses Gif

Protecting your eyes from damaging UV rays is easy and you look freakin cool doing it. UV rays attribute to almost every possible vision problem out there; Vision Loss, Cancer, Macular Degeneration, Ptygerium, and many more. 


2. Eat a green lunch

Abu Eating Fruits Gif


Studies show eating the right foods helps with maintaining eye health. Try choosing kale, spinach, salmon or veggies instead of just grabbing that sandwhich from the deli next door. 


3. Take a 20 minute break from the keyboard

Jim Carey Typing Keyboard Computer


Screen-induced eye strain has an official name, if not a surprising one:computer vision syndrome. So for all you ophthalmogy doctors using EHR and EMR software like io Practiceware, be sure you take a 15 minute break - or a long lunch! 

4. Roll your eyes ~ seriously!

Tina Fey Eye Roll


Excersizing your eyes is important, like all parts of your body they need movement too!


5. Moisturize 

The Office Eye Blinking

Keep your eyes looking young and fabulous by moisturizing daily. Your eyes show signs of aging quicker than the rest of your skin due to the thinness of the skin and how much it moves every time you blink, squint, or smile. 


6. STOP rubbing your eyes!

Rub Eyes Monsters Inc

We know its cute but its soso bad for you! Rubbing your eyes breaks tiny little blood vessles in your eyelids causing dark circles. If you have itchy eyes, see your eye doctor!


7. Get a good nights sleep!

Sloth Kitty Go Sleep Now

Not enough sleep can cause bloodshot eyes, twitching, dry eyes, itchy eyes and dark circles. Rest up people! The Zombie look doesn't look good on anyone.




Everything you do plays a role in protecting your peepers. So make sure you take the necessary steps to prevent some pretty serious eye conditions in the future. Your 65 year old self will thank you! 


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Topics: Vision, Health, Improve Vision, Eye Importance

Think Before You Eat!

Posted by Jaime Davis

Jul 10, 2014 1:47:35 PM

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Topics: Cataracts, Macular Degeneration, Food, Vitamins, Vision, Health

EMR vs EHR: What's the difference?

Posted by Amal Doleh

Jun 26, 2014 4:02:00 PM

question_markMany people use the terms "electronic medical records" (EMR) and "electronic health records" (EHR) interchangeably. But did you know the two are actually different from one another? Although EMRs came along first, they were mostly used for diagnosis and treatment, hence the word "medical" in the title. The word "health" in EHR consists a whole lot more territory than "medical" in EMR. EHRs are capable of going a lot further than EMRs.

Let's break it down, shall we?

Electronic medical records (EMR) are essentially a digital version of paper charts in the doctor's office. These records contain the medical and treatment history of the doctor's patients in one practice. EMRs have many advantages over outdated paper records as they allow doctors to:

  • Track data over time
  • Easily identify which patients are due for preventive screenings or checkups
  • Check how their patients are doing in terms of blood pressure, readings, vaccinations, etc.
  • Monitor and improve overall quality of care within the practice

Even with these benefits, EMRs do not come without disadvantages. In fact, information in EMRs does not travil easily out of a practice. Some even have to be printed and delivered by mail to specialists. In that case, EMRs are not so much better than paper records.

Electronic health records (EHR) do everything EMRs can...and then some. They focus on the total health of a patient, essentially going beyond standard clincal data collected in the office. EHRs focus on reaching out beyond the health organization that initially collects and compiles patient information. They are designed to share important information with different clinicians, laboratories, specialists, etc., and so contain all the information from all the clinicians involved in a patient's care. 

Information moves with the patient, whether to different practices, hospitals, states and countries. EHRs are there to not only make it easier for doctors, but for patients as well. With this records system, patients, along with their doctors, can access their own records - an expectation in the Stage 1 definition of "meaningful use" of EHRs.

With well-implemented, fully functional EHRs, all members in a healthcare team have readily available information that allows for more coordinated patient care. With EHRs:

  • Any information collected by a patient's primary healthcare provider can tell the emergency department of a patient's life-threatening allergy to avoid improper care, even while the patient is non-responsive.
  • Patients are able to log on to their own records and monitor the trends of their lab results over a set period of time, which, in turn, can help motivate the patient to lead a healthier lifestyle.
  • Lab results are readily available so doctors do not have to run duplicate tests.
  • Notes from doctors about a patient's stay in a hospital can help with discharge instructions and follow-up care, making the move from one care organization to another an easy one for patients.

So you could definitely say there's a difference between "electronic medical records" and "electronic health records" that is more than the one word. One word can make a world of difference.

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EHR & the Data of Health Care Infographic

Posted by Amal Doleh

Jun 20, 2014 10:50:00 AM


Brought to you by datascience@berkeley: Masters of Data Science


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Come visit us at Masters in Ophthalmology!

Posted by Amal Doleh

Jun 16, 2014 12:28:00 PM


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The Necessary Evolution of EHRs

Posted by Amal Doleh

Jun 4, 2014 11:32:12 AM

As EHR adoption rates grow, physicians are finding that the technology may not be suitable for their needs. A majority of these doctors are using systems that do not fit their needs. Frustrations are growing as adoptors feel that some of these systems are decreasing their practice efficiency yet meaningful use requires physicians to use an EHR. This is why choosing an EHR for your practice must be carefully considered and all factors must be heavily weighed.

Many physicians who chose their EHRs wisely praise this technology as it has increased the speed of their workflows as well as patient satisfaction. No one would argue about the value of EHR systems, especially if their goal would be to achieve a significant degree of interoperability - a potentially life-saving outcome (Girgis, HealthITSolutions, 2014).

The evolution of EHRs is necessary and there are many factors that need to be considered:

  • Custimization - doctors have different needs, EHRs must have the option of custimization to help increase a practice's workflow.
  • EHR Vendors - it is important that these vendors completely understand the needs of their targeted market. Understanding what these doctors need helps in EHR adoption and implementation.
  • Integration - things like test results need to be easily uploadable in the EHR system.
  • Interfaces - priority should be taken when being built. It is important for practices to be able to interface with their systems.
  • Notes and Readability - physicians need easy access to patient notes that are not pages and pages of irrelevant materials, something they would have to dig through in order to find what they need.
  • Accessibility - there is a significant importance when it comes to accessing information from outside physician practices so it is crucial that EHRs create a process of easy accessibility.

In summary, EHR adoption and implementation is a tricky yet necessary process. EHRs are shown to improve patient care and create organization in medical practices and hospitals. EHRs can greatly improve our tracking systems and insure all our patients get needed tests done and that they return for follow up when they should. It is much more efficient doing this with EHRs than with paper charts and, when systems truly become interoperable, healthcare throughout the medical ecosystem will improve. But, to get there, much work and evolution is still needed. And unless you include the end users in the discussion and development, chances are that this is more a dream than a reality (Girgis, HealthITOutcomes, 2014).

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Topics: software

CDC Report: EHR adoption among office-based physicians reaches 78%

Posted by Amal Doleh

May 23, 2014 2:19:00 PM


A new report released this week showing electronic health records (EHRs) adoption by office-based doctors showed a 37% increase in EHR usage. In 2013, 71.8% of office-based physicians reporting using any type of EHR system, up from 34.8% in 2007. Data was collected through in-person interviews and mail surveys. Researchers speculate the significant increase in adoption rates is a result of the Health Information Technology for Economic and Clinical Health (HITECH) Act passed in 2009, which gives healthcare providers incentive money for implementing an EHR system. 

Although many practices are using EHRs, many doctors are still in the beginning stages of adoption, using the system for basic tasks such as recording patient histories. The HITECH Act requires physicians to implement these EHRs in a "meaningful" way (in compliance with Meaningful Use - MU), which includes things like using the EHR to order tests and send prescriptions digitally. While the results indicated a large increase in adoption, it was also found that it took more than two years from the system installation date for doctors in a large practice to actually use a new commercial EHR. 

Three types of EHR systems were researched in this study: any type of EHR system, a basic system, and a fully functional system. Both the "basic system" and the "fully functional system" were defined by functionalities that the system had. Although a fully functional system includes more features than a basic system, it does not include all of the features required for Meaningful Use objectives. In other words, having a system that meets the criteria of a fully functional system does not necessarily mean the system would meet MU requirements. Regardless, during the 2007-2013 period, use of any type of EHR and adoption of a basic system both increased in all categories of doctor specialty and practice size.

The increase is also largely due to the pressure doctors are starting to feel in regards to the looming penalties on their Medicare and Medicaid payments if they don't comply with the government's EHR requirements by the end of 2015. Not only will physicians need to adopt an EHR, but with Meaningful Use, they must rework their practice's workflows and this is not a quick task. Government incentives have definitely helped in the sharp adoption increase, but implementing a new system takes time.

It's important to choose a system that you feel will best suit your practice and one that you and your staff will take the time to learn as it is there to help improve overall workflows.


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How To Get More Out of Your EHR: A Consultant’s Perspective

Posted by Amal Doleh

May 12, 2014 10:46:00 AM

Aspen Advisors’ Fran Turisco gives the lowdown on advancing with EHRs post-implementation

A recent survey from the American Hospital Association (AHA) conducted between November 2013 and February 2014 found that hospital adoption of electronic health record (EHR) systems has increased more than five-fold over the last five years. Specifically, 93 percent of hospitals in 2013 reported being "in possession" of an EHR system that received meaningful use certification, according to the survey’s data. 

However, while the overwhelming majority of healthcare organizations across the country have implemented EHRs, it’s the work that is done post-implementation that will have a greater impact on how a health system succeeds. Indeed, organizations are faced with increasing pressure to deliver clinical and financial results demonstrating the benefits of their implemented EHRs. As such, using the technology to achieve health and efficiency goals—such as attesting to meaningful use, and then population health and care management—should be a high priority at patient care facilities.

Fran Turisco, a principal with the Denver-based Aspen Advisors—a healthcare consulting firm that helps organizations streamline operations through the strategic and effective use of technology— recently spoke withHealthcare Informatics Assistant Editor Rajiv Leventhal about strategies for EHR optimization, what organizations are currently doing wrong, and the direction the industry is going in terms of post-EHR implementation. Below are excerpts of that interview.

Now that so many organizations have their EHRs implemented, what are the next steps?

What putting the EHRs in did was provide the foundation in terms of functionality and data. Now organizations have a lot more data, so they are working on initiatives—call it data analytics or clinical analytics—to take the data and do interpretation and measurements so you can assess your quality and risks, and see what your care outcomes are. That’s really the whole emphasis behind meaningful use Stages 1, 2, and 3, and part of Stage 3 is outcomes-driven. So they have the data, and a lot of organizations are focusing on understanding where they are by using the data to come up with meaningful metrics and dashboards to monitor how things are going.  Another area where we are seeing activity, after getting the basics in and meeting meaningful use, is customizing the EHR so it has alerts that they think are important; evidence- based protocols that they want to follow; and advanced alerts for patient safety issues. And they’re also creating more and refining their order sets.

After implementation, do organizations try to mimic all their old paper processes and workflow? Is this smart?

It depends how long they’ve had the EHR in. We always tell organizations that this is a great opportunity to look at your new technology, but also your processes. Some do, but some feel that they have to get the system in by a deadline. Afterwards, many go through what is almost like a process improvement care redesign. We just recently finished with a client that had difficulties with standardization of where data is, as well as physician documentation and medication reconciliation, so they created this whole program and had a “tiger team.” We did five different initiatives and measured the before and after to show improvement, and not only does it help the organization, we saw that it really got physicians jazzed up.  So it was a win-win, and now we see a number of organizations looking at things like that, determining what works versus what won’t work now that the technology is there.

On that note, how important is physician adoption to the optimization process?

I would say clinician adoption varies based on the level of involvement and decision making during implementation. If there is a lot of involvement—and if physicians want to be involved—then you get great adoption. At other places, they see it as an IT initiative, and it becomes a “we have to do it because we won’t get paid for it otherwise” situation. They might do what they need to do, but it’s checking boxes as opposed to looking at the underlying reason for why it’s being done in the long run. Some don’t see that [this technology] is capturing data for metrics, research, and education.

What are organizations doing wrong when it comes to post-implementation? Is poor planning a big issue?

In the long run, yes, planning is of course critical to success. There are two organizations I am working with right now. One multi-hospital system implemented its EHR [almost two years ago], and the other one is a hospital that implemented last August. The one that has been up and running for [almost two years] is now customizing for the particulars of the different hospitals. The other organization that just installed it is still dealing with a lot of basic issues. I don’t believe that there is any way to optimize the processes and technologies before you get it in; you’re lucky if you get 80 percent there. Organizations expect that there will be some level of optimization, whether they feel like it’s a great opportunity to change their workflows and fine tune their systems, or their workflows are fine but their system needs to be enhanced, standardized, and optimized to get more out of it. It really depends on the organization.

The other thing we’re seeing is that [optimization] allows organizations to play in the health information exchange (HIE) sandbox. So with the hospital that has been up and running for [almost two years], I talked to the CIO recently, and he said, “We’re connected using Epic, and we have exchanged 2,500 records. Isn’t that wonderful? Someone in Boston could travel to Denver and if something happens, we have their information.” He was truly amazed.  I think that’s another area—as organizations are starting to embrace value-based care, accountable care, and collaborative care—that they need these systems in place for, or there’s no way they can exchange and share data. It’s part of the entry into the accountable care world.

A lot of organizations are starting out as “view only,” but are moving into shared protocols and shared care delivery. Time is preventing them from getting from one phase to the other, but also it is new to them and is a culture shock. They’re not used to sharing and they don’t want to share. And they’re also not quite sure how they will operate in an accountable care environment. Over a year ago, one organization asked us to build a technology roadmap for its new accountable care organization (ACO), and at the time, it hadn’t even figured out how it was going to conduct business. So we’re asking, “What quality measures do you need and what do we need to set up for care protocols?” And their response was, “We’re working on that.” So folks are dipping their toes into data sharing and data collaboration. It’s still very early in the process, you need to remember that.

What else do you see on the horizon for organizations deploying their EHR strategies post-implementation?

Another thing that is important now is that if you pass Stage 2, there is this whole patient engagementconcept with patient portals. We are seeing organizations using the patient portal part of the EHRs to not only engage the patients, but also the family members. Even with things such as appointment reminders and simple things like health assessments and educational information, you’re fitting in contact with the patient, which is really important. You’re allowing the patient to use the portal to communicate with the provider. We’re seeing that a lot.

The reality of healthcare reform is that we now need to manage populations—we are now responsible for that. And they will find new and innovative ways to care for patients rather than seeing them in person. So we’re getting there, but slowly. It’s both exhausting and exciting, but really, I think the fun is just beginning in terms of technology. 

         Fran Turisco

Original Souce:

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Survey: Do Patients Really Care if You Use Your EHR in the Exam Room?

Posted by Melissa McCormack

May 6, 2014 10:57:00 AM

Many physicians worry that using an electronic health record (EHR) system in the exam room may damage the patient experience. We covered this issue a while back, offering physicians advice on how to maintain patient interaction even while using an electronic charting device during exams.

Yet many physicians still hesitate to embrace EHRs in the exam room. Even in practices where EHR software has been implemented, many doctors continue to use paper during exams, documenting notes in the EHR only after a patient visit has concluded. The idea behind this method is to preserve the patient experience, but recording the same notes twice is extremely inefficient for physicians, wasting precious time that is already quite limited.

But what do patients think? Do they really care if their doctors use electronic devices to take notes during exams? We surveyed a random sample of 4,500 U.S. patients, collecting a minimum of 500 responses to each question, to find out how patients feel about doctors using EHRs at the point of care and what truly impacts the patient experience. Here’s what we learned.

Most Patients Don’t Mind Electronic Note-Taking During Exams

We asked patients three separate questions: whether it would bother them for their doctor to type on a desktop computer, on a laptop computer and on a tablet during an office exam. The overwhelming response to all three questions was, “No.”

Patient Concern With Use of Electronics During Exams

In each case, more than 80 percent of respondents indicated they would not be bothered. On a sliding scale, patients indicated the least concern for doctors using tablets during the exam.

Patients Showed More Concern Over Scribes Typing Notes

Next, we asked patients about the extent to which they’d be bothered by doctors using scribes, meaning third-party assistants who transcribe patient visit notes into an electronic chart while the doctor conducts the exam.

Patient Concern With Use of Scribes During Exams





Some two-thirds of patients still indicated they wouldn’t be bothered by this practice. However, patients were almost twice as likely to express concern over the use of scribes than over the doctor typing directly into a computer.

Patients Are Most Concerned About Audio Recordings

About 60 percent of patients indicated that they wouldn’t be bothered by the prospect of doctors using tape recorders to record medical notes during an exam. However, of all the methods we asked about in our survey, patients expressed the most concern over audio recording.

Patient Concern With Use of Audio Recording During Exams

Ultimately, over one-third of patients said they’d be bothered by doctors using tape recorders to assist in charting medical notes. Specifically, patients at the furthest end of the spectrum—those who chose “would bother me a lot”—were more prevalent when it came to tape recordings than with any other method of charting during an exam.

Patients Prefer EHRs Over Paper During Exams

Our first few questions established that patients aren’t concerned by doctors using EHRs during exams. But that doesn’t necessarily mean they prefer EHRs to paper—so next, we explicitly asked them for their preferences regarding paper versus digital charting during visits.

Patient Preferences for Point-of-Care Charting Methods

Here we see that nearly half of patients surveyed had no preference between doctors using EHRs or using pen and paper at the point of care. However, if we filter down only to patients with a preference (i.e. if we eliminate “absolutely no preference”), the support for EHRs is significant.

Patient Preferences for Paper Vs. EHR at the Point of Care

It’s important to note that we specifically asked patients about what method they prefer doctors to use during an exam, at the point of care. This means, for example, that doctors who use paper in the exam room and then add notes to their EHR afterward would be acting against patient preference, according to our data.

Additionally, I was interested to find that these preferences are similar for both genders and all age groups. The percentage of patients with no preference grows as age increases (in other words, older patients are less likely to have any preference one way or the other). But in all cases, preference for EHRs dominates preference for paper charting during exams.

Non-EHR Factors More Strongly Impact Satisfaction

If EHRs don’t create negative patient experiences, as some doctors have feared, then what does? We asked patients which factors most impact their satisfaction with a visit to the doctor. Specifically, we asked whether a negative experience with each of several factors would decrease patients’ satisfaction with their doctors.

Factors With Strongest Negative Impact on Patient Satisfaction

Patients indicated that long wait times at the doctor’s office, unfriendly staff and short duration of visits with the doctor would most drive dissatisfaction. The prospect of their doctor typing on a computer during the exam had the smallestnegative impact, with only 5 percent of respondents indicating this would drive dissatisfaction.

Here again, I found these preferences to be similar for both genders and all age groups. Wait times, staff friendliness and duration of visits rotate in and out of first place for different age groups. But “doctor typing on a computer during the exam” is the smallest percentage for every age group, as well as for both males and females.


Despite publicized concerns about the negative impact of EHR use during exams on patient satisfaction, our study demonstrates that patients by and large care very little about their doctors using EHRs at the point of care. In fact, to the extent they have preferences, patients distinctly prefer that doctors use EHRs over using paper to take notes during visits.

Patients ranked tablets the most preferable method of electronic charting, followed closely by laptops and desktop computers. Patients were slightly more concerned by the use of scribes, and even more so by the use of tape recorders, perhaps due to privacy issues (such as those raised by both doctors and patients regarding the prospect of introducing an additional entity to the exam). Still, more than half of the patients surveyed said they wouldn’t be bothered by scribes or audio recordings, either.

Our advice to doctors would be to embrace EHR technology—and, for those already using it, not to shy away from using electronic charting at the point of care. For doctors who want to minimize patient dissatisfaction, energy is better focused on the factors that most impact the patient’s perception of the visit: wait times, staff friendliness and visit duration.

To further discuss this report or obtain access to any of the charts above, feel free to contact me at

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