Ophthalmologists’ Input Shapes an EHR System

Designed by doctors who learned how to code, not the other way around.

By David A. Goldman, MD

Physicians know physicians, but software coders and engineers do not (usually) know medicine. When I was selecting an electronic health record (EHR) system for my practice, I found Modernizing Medicine’s suite for ophthalmologists, modmed Ophthalmology, intriguing because it was developed by doctors who were taught how to code software—not the other way around. It is reassuring to me that fellow ophthalmologists had, and continue to have, instrumental voices and guiding hands in the research and development associated with Modernizing Medicine’s ophthalmology EHR platform, the Electronic Medical Assistant (EMA) Ophthalmology.

My attention was drawn to EMA Ophthalmology and modmed Ophthalmology because the development team understands the value of the ophthalmologist’s time and strives to save it. The EHR platform seamlessly integrates into my practice and knows my workflow, increasing overall efficiencies and enabling me to spend more time doing what I love—helping patients—rather than spending my “extra” time attempting to complete administrative tasks in poorly designed software or, even worse, on paper. The right technologies should help to reduce the administrative burden increasingly faced by ophthalmologists and help us feel confident that we will be paid for the work we do.


The modmed Ophthalmology suite is cloud-based, and I can access the native EHR system directly from my computer, iPad, iPhone, or Android applications. The advantages to my practice include the system’s flexibility, mobility, and modernity. It is a treat that I no longer have to depend on an information technology department to be confident that my practice is running smoothly. The convenience factor is huge. Each time the software is updated, it is done automatically through the cloud, at no extra charge and with no hassle.

The iPad application enables keyboardless documentation, which allows me to walk around the room, touch and tap the screen throughout an exam, and generate notes efficiently. Most important, the iPad actually enables and encourages face-to-face patient interaction and is easy to use as a tool for patient education.


Because modmed Ophthalmology does not run on macros or templates, I am not troubled with trying to fit a complex patient into a preset template that might not address the intricacies of the case properly. The EHR system was built by practicing ophthalmologists, so it knows my workflow right out of the box. If I input data once, the system is able to use this information for multiple purposes, including creating a superbill that documents exactly how I treated the patient, saving me time.

Modmed Ophthalmology also uses adaptive learning, so the system actually learns and remembers my individual preferred settings and most common courses of action. Like a helpful ophthalmic technician, it anticipates what I need without asking. In addition, I can create master visits for frequently encountered conditions and then apply these user-designed protocols to routine visits, new patient examinations, and pre- and postprocedure instruction. When a patient comes in for a cataract evaluation, for example, I can automate my counseling of the patient with one button click; the system prompts discussion of lens options, ordering of postoperative drops, and ordering a return visit for optical biometry.


The system supports data-driven patient care by collecting structured data, and I can longitudinally track whether an individual patient’s condition is improving or declining from visit to visit. For example, I can track a patient’s intraocular pressure or central retinal thickness over time and then quickly produce a global view of how that patient is responding to treatment.

In addition, I can use deidentified data from patients and physicians across the country to learn about preferred treatments for almost any disease. From a rare condition such as retinoblastoma to a more common malady that in one patient has resisted first and second treatments, the platform provides me with information directly from my peers regarding their firsthand experiences with a variety of treatment options.


Modernizing Medicine’s analytical tools allow me to generate real-time comparative benchmarking of quality, cost, and financial viability, which can help improve my practice’s bottom line. The system’s ability to collect structured data during patient visits will facilitate a smoother transition to quality-of-care reporting and outcome-based reimbursements.

Physicians are already aware of Centers for Medicare and Medicaid incentive programs such as the Physician Quality Reporting Standards or PQRS and meaningful use of EHR. Soon, however, it will be important for us to familiarize ourselves with the Merit-Based Incentive Payment System, or MIPS; the Medicare Access & CHIP Reauthorization Act of 2015, or MACRA; and Quality Payment Programs, which will have the ability to make a significant impact on the financial success of your practice and your take home pay in the very near future. [For more on these programs, see Cheezum article, page XX.]

Now is the time to implement the right technology to ensure that you are prepared for these programs. Because patient data in EMA Ophthalmology is electronically captured, I can review how I am doing in real time, compare my results with those of my peers, and make any necessary changes quickly to ensure that I am reimbursed for the work I do. With the impending MACRA and MIPS programs expected to particularly affect specialty care, this will be especially important for ophthalmology. The time is right to stop wasting hours scanning charts and start preparing for the future.


Ophthalmologists need to quickly translate what we see in our examinations onto the screen, and touch-based technology is the perfect vehicle for this. One of my favorite capabilities of modmed Ophthalmology is a result of Modernizing Medicine’s partnership with the health care media company Rendia (previously known as Eyemaginations). My dialogue with patients has become more engaging, rich, and meaningful thanks to this educational software that includes clinical artwork and interactive technology. I use the program’s 3-D animated videos to explain diagnoses and treatments, such as a retinal tear or a cataract removal, to my patients in a way that is easy to understand. The system automatically queues up relevant content for each patient. This has helped to empower the health care decision-making of my patients.


There is no question that technology is fast evolving in all arenas, including the dynamic health care field we all live and breathe in daily. I have found each new advancement with this EHR system to be physician-centric and consciously thought out to support ongoing adaptability and continuous improvement of efficient workflow.

Recently, Modernizing Medicine launched modmed 5.0, with an even more intuitive user experience throughout the modmed Ophthalmology suite on both iPad and desktop versions. The update was targeted to address ophthalmologists’ diverse and ever-changing needs and to further reduce the administrative burdens of physicians to help alleviate burnout. A few of my favorite features are

• practice management: a modern all-in-one system for scheduling, document management, billing, and reporting designed to help improve practice workflow and boost patient payments

• clinical labintegrations with Quest and Labcorp;

• smart PQRS measures for cataracts and retinal detachment

• meaningful use objective 10: ophthalmology-specific registries for dry eye syndrome and primary open-angle glaucoma

• contact lens improvements

The future of EHR systems in ophthalmology is promising. Ophthalmologists need EHR systems that provide data analytics and enhance patient engagement. Existing EHR platforms will not be able to provide the necessary benchmarking needed for future reporting requirements. I am happy to be able to move forward with this ophthalmologist-designed system, and I highly recommend it to my peers. n

David A. Goldman, MD
• Private practice at Goldman Eye, Palm Beach Gardens, Florida
• (561) 630-7120; david@goldmaneye.com
• Financial interest: Ophthalmology Team Lead, Anterior Segment, Modernizing Medicine