Inside the EHR Black Box: What’s Helping, What’s Hurting, and What’s Next for Optometric Tech

Power Hour Optometry
Host: The Power Practice
Release Date: June 12, 2025
Panelists:

• Eugene Shotsman (Host)
• Kelly Kirkcsik (Director of Professional Affairs at Revolution)
• Charlie Beagle (President of iFinity)
• Dr. Anthony Sesto (Practicing Optometrist in Michigan and Tech Innovator)

Introduction and Panel Overview

In this enlightening episode of Power Hour Optometry, host Eugene Shotsman facilitates a comprehensive panel discussion with industry experts Kelly Kirkcsik, Charlie Beagle, and Dr. Anthony Sesto. The focus is on Electronic Health Records (EHR) systems within optometric practices—exploring their evolution, current challenges, and future innovations.

Eugene Shotsman sets the stage by highlighting the episode's aim: to synthesize common frustrations with EHR systems into insightful discussions without any commercial bias. He introduces the panelists and outlines the wide range of topics to be covered, including AI integration, workflow automation, and the true costs associated with EHR platforms.

Evolution of EHRs in Optometric Practices

Charlie Beagle kicks off the conversation by tracing the dramatic transformation of EHRs over the past five years. He notes that EHRs have shifted from being mere documentation tools to becoming the operational backbone of modern practices.

“EHRs in the past have been primarily documentation tools, digital filing cabinets, if you will, and today they're really the operational backbone that determines whether a practice thrives or struggles.”
— Charlie Beagle [02:48]

Charlie emphasizes the growing expectations of practices, which now demand comprehensive systems capable of handling patient engagement, business intelligence, compliance management, and revenue optimization. He introduces the concept of invisible integration, where technology seamlessly integrates into daily workflows without disrupting the practice's operations.

Kelly Kirkcsik adds that the COVID-19 pandemic significantly accelerated the integration of technology within practices. The necessity for remote operations, efficient communication, and flexible staffing models pushed EHR systems to the forefront of practice management solutions.

“The COVID pandemic certainly played a really large role. It triggered a huge push where technology implanted itself in the center of the practice to help with all the communication pieces.”
— Kelly Kirkcsik [05:09]

The Impact of COVID-19 on EHR Adoption

Kelly Kirkcsik elaborates on how the pandemic unveiled unforeseen needs within medical practices. She points out that technologies enabling remote work, efficient communication, and flexible staffing became critical overnight, reshaping the traditional operational paradigms of optometric practices.

“Practices had to transition to the way they operate as a result of the technology that was needed during that time.”
— Kelly Kirkcsik [06:50]

This shift underscored the importance of adaptable and integrated EHR systems that could support not only clinical functions but also administrative and operational efficiencies.

Communication and Integration Challenges

The panel delves into the persistent challenges of communication between different healthcare entities. Kelly Kirkcsik highlights the difficulties in inter-office communications, especially when referring patients to specialists or collaborating with hospitals and laboratories. She advocates for a unified system where all EHR platforms can communicate seamlessly, eliminating the need for manual processes.

“It would be nice to get to a point where even if all systems look different and have unique features, we're all speaking the same language.”
— Kelly Kirkcsik [08:50]

Charlie Beagle echoes these sentiments, emphasizing that poor communication not only hampers efficiency but also impacts patient care. He stresses the need for EHR systems to support both external referrals and internal patient interactions effectively.

Human Factors: Training and Utilization

A significant portion of the discussion centers on the human element—how staff interact with EHR systems. Dr. Anthony Sesto shares his firsthand experiences, identifying system slowdowns and inadequate training as major sources of frustration within practices. He criticizes the "telephone game" training approach, where knowledge is diluted as it passes through multiple layers of staff, leading to misunderstandings and underutilization of EHR features.

“A lot of those frustrations... are about the training that the provider's office assigns someone who's not the doctor to do the training on it.”
— Dr. Anthony Sesto [16:35]

Kelly Kirkcsik concurs, noting that as EHR systems become more sophisticated, the learning curve steepens. She compares EHR updates to smartphone operating system updates, where continuous learning is essential to fully leverage new functionalities.

“A lot of times it's just a challenge for practices to keep up with the pace of innovation.”
— Kelly Kirkcsik [14:43]

Underutilized Features and Efficiency Gains

The panel sheds light on the often-overlooked features within EHR systems that can drive significant value if properly utilized. Kelly Kirkcsik points out that many practitioners remain unaware of the full capabilities of their EHR systems, missing out on features that could enhance efficiency and patient care.

“Many of our EHR customers don't realize that they're not utilizing all the features available to them.”
— Kelly Kirkcsik [24:10]

Charlie Beagle advises practices to conduct quick audits of their workflows to identify areas where EHR integrations can eliminate inefficiencies, such as automating data entry from medical equipment or streamlining claims processing.

The Role of AI in EHRs

AI integration is a hot topic, with the panel discussing its potential to revolutionize EHR functionalities. Charlie Beagle introduces iFinity’s AI-assisted scribe, designed to reduce documentation time by 50% while improving note quality. He emphasizes that AI should augment, not replace, practice staff, enhancing their efficiency in tasks like claims assistance and patient readiness.

“Our scribe agent is an AI-assisted scribe that really goes beyond transcription. It's ambient listening that understands optometric workflows and suggests structured note elements.”
— Charlie Beagle [30:31]

Kelly Kirkcsik echoes this perspective, highlighting AI’s role in minimizing administrative burdens and enhancing patient interactions through features like automated documentation during exams and streamlined letter generation.

Dr. Anthony Sesto envisions a future where AI automates routine administrative tasks, such as eligibility checks and claims processing, allowing practitioners to focus more on patient care.

“AI integration... could just talk and then you're basically talking to the patient and it's backfilling the chart for you.”
— Dr. Anthony Sesto [33:13]

Change Management and Best Practices

Implementing new EHR systems requires effective change management. Charlie Beagle underscores the importance of training and continuous education to help staff adapt to new technologies and workflows.

“Change management is a huge issue for practices. It's difficult for all of us.”
— Charlie Beagle [26:28]

Dr. Anthony Sesto shares his approach to fostering a culture of continuous improvement, encouraging staff to stay engaged and proactive in learning new system functionalities to prevent complacency and frustration.

“I like to keep changing things so that staff don't get complacent. It keeps them really engaged.”
— Dr. Anthony Sesto [27:30]

Evaluating and Selecting an EHR System

When considering an EHR upgrade, the panel advises practices to look beyond initial costs and evaluate the total cost of ownership, including training, integration, and scalability. Charlie Beagle warns against focusing solely on price, as cheaper solutions may incur hidden costs related to inefficiencies and compliance risks.

“They focus on price instead of total cost of ownership. The real cost isn't the monthly subscription, it's the opportunity cost of inefficient workflows.”
— Charlie Beagle [47:00]

Kelly Kirkcsik and Dr. Anthony Sesto add that practices should assess whether an EHR system can accommodate future growth and evolving practice needs. They recommend asking potential vendors about their financial stability, security measures, and support for change management.

Key Questions to Ask EHR Vendors:

1. Financial Stability:
   “What's the company's financial stability and staying power?”
   — Charlie Beagle [51:11]

2. Security and Compliance:
   “How will the system protect my practice if something goes wrong?”
   — Charlie Beagle [51:40]

3. Scalability and Support for Growth:
   “What happens when my practice grows?”
   — Charlie Beagle [52:38]

4. Change Management Support:
   “How can you help my team adapt to the change?”
   — Charlie Beagle [52:38]

Future Trends and Innovations

Looking ahead, the panel discusses emerging trends that will shape the future of EHR systems in optometry. Charlie Beagle highlights the shift towards patient-owned data, where healthcare information becomes more accessible and portable through smartphone apps like Apple Health. This approach aims to enhance patient experience and outcomes by facilitating seamless data sharing across different providers.

“We're looking at how other industries have transformed customer experiences while maintaining security and compliance.”
— Charlie Beagle [36:22]

Kelly Kirkcsik envisions AI playing a pivotal role in enhancing doctor-patient interactions by automating documentation and administrative tasks, thereby allowing practitioners to focus more on patient care.

“We give that power back to the doctor... AI is taking the information that the doctor's saying to the patient and backfilling the chart.”
— Kelly Kirkcsik [43:11]

Dr. Anthony Sesto anticipates AI-driven solutions that manage claims and billing automatically, reducing denial rates and improving cash flow for practices.

“AI that's going to help a practice take care of its revenue management and stuff like that and get it paid.”
— Dr. Anthony Sesto [35:09]

Key Takeaways

1. EHRs as Operational Backbones: Modern EHR systems are integral to the success of optometric practices, handling everything from clinical documentation to business operations.

2. Importance of Integration: Seamless communication between different healthcare systems and internal workflows is crucial for efficiency and patient care.

3. Underutilized Features: Many practices do not fully leverage their EHR systems’ capabilities, often due to inadequate training and awareness.

4. AI as an Augmenting Tool: Artificial Intelligence holds significant potential to streamline administrative tasks, enhance documentation, and improve overall practice efficiency without replacing staff.

5. Comprehensive Evaluation for EHR Selection: When choosing or upgrading an EHR system, practices should consider total cost of ownership, security, scalability, and vendor support beyond initial pricing.

6. Future-Oriented Innovations: Patient-owned data and advanced AI integrations are set to revolutionize how EHR systems support both practitioners and patients in the coming years.

Conclusion

The panel concludes by encouraging practices to delve deeper into their current EHR systems, exploring available features and staying informed about upcoming innovations. By doing so, optometric practices can harness the full potential of EHR technology to enhance both operational efficiency and patient care.

“Every practice that's listening to the show is using an EHR in some capacity every single day. I'm hoping that some of the nuggets that you heard today help you at least look a little bit deeper.”
— Eugene Shotsman [57:11]

This episode of Power Hour Optometry provides invaluable insights into the evolving landscape of EHR systems, offering actionable advice for practices looking to optimize their technological infrastructure for better efficiency and patient outcomes.