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Department: Technology

EHR Helps Physician Practice Cut Errors and Delays
Palm Beach Obstetrics & Gynecology, PA, offers an excellent example of a medical group that achieved outstanding success by implementing an electronic health record (EHR) system. As a result of installing an EHR in 2006, the group streamlined workflow, increased revenue, reduced its staffing needs, improved billing and coding, and eliminated a significant amount of overtime.

How IT Would Benefit Medical Homes
A recent report, Meaningful Connections: A resource guide for using health IT to support the patient centered medical home, from the Patient-Centered Primary Care Collaborative (at www.pcpcc.net), in Washington-D.C., contains case study examples of how medical homes would work in practice. In the report, physicians and others in PCPCC member practices that are currently certified as patient-centered medical homes (PCMHs) or considering becoming certified describe the effects that health information technology (HIT) has had on their practices and patients.
These case examples provide insight, in the words of the practitioners themselves, into the effect that HIT can have on primary care. In particular, of the 19 examples provided in the report, seven mention the effect HIT has had on helping practices manage the care of patients with diabetes. The section was prepared based on responses to questions PCPCC sent to its member practices.

EHR Boosts Clinic’s Efficiency
Three years ago, the Valdez Family Clinic of South San Antonio, Texas, was seeking an electronic health record (EHR) to replace the paper charts it had used for years. But the clinic staff did not want just any EHR off the shelf. Family physician Alicia V. Valdez, MD, and her staff had extremely ambitious goals for the EHR including improving cash flow, boosting efficiency and patient care, while also cutting the hours of operation.

The system the clinic chose helped the practice meet all of the goals it set. In fact, the clinic was so successful in implementing the EHR that
it was one of the winners in 2007 of the Healthcare Information and Management Systems Society (HIMSS; at www.himss.org) Nicholas E. Davies Award of Excellence, in the Ambulatory Care category. The clinic’s application for the Davies Award, which can be viewed on the HIMSS Web site, describes the clinic’s reasons for adopting an EHR system, and the success it had with it.

Do Medical Homes Need Online Tools?
Healthwise (at www.healthwise.org), a nonprofit organization in Boise, Idaho, has released a report, The Virtual Health Home: The Dashboard for Health and Health Care, by Donald W. Kemper, MPH, and Leslie Kelly Hall. Kemper is Healthwise’s CEO and Hall is its senior vice president.

The report sets forth the concept of an online health resource for patients that is designed to be used in conjunction with the care offered in a medical home. As Kemper and Hall explain, the care provided in a PCMH is given from the perspective of health professionals looking and managing inward, toward the patient. The virtual health home (VHH) is an outward-facing tool that a patient uses to coordinate and manage his or her own care.

How to Avoid EMR Buying Mistakes
As most physicians know, implementing an electronic medical record (EMR) system can be costly and complicated. While some advocates view universal adoption of EMRs as a crucial step in addressing many of the problems physicians face every day, many doctors remain skeptical of their value and are reluctant to make a significant investment in this technology.
Large hospitals and health care organizations have long recognized the value of EMRs. Small and medium-sized practices and physicians in solo practice, however, tend to view them as an expense that contributes little value to a busy practice when weighed against the additional work involved to choose, buy, install, and learn these systems.

Search Services Get More Specific
Have a moment to spare? That’s good, because most busy clinicians have little time to waste. You have probably just reached the end of a long practice day, and have a few unanswered questions that linger from the 20 or so patients you have seen. You would also probably like a quick, easy way to find relevant and recent answers to your questions. You would no doubt like those answers to be authoritative and targeted to your specialty or to problems confronted recently.

You are most likely Internet-savvy and have probably already gone to the all-encompassing Google, or maybe PubMed, the massive U.S. government Web site, for your answers. You have most likely found that these sites too often yield long lists of articles or bits of information that take too long to scroll through and often are clinically irrelevant or outdated.
Not so long ago, there were few options available online for physicians seeking answers to questions about practice management. Today, however, the Internet presents a host of useful options for finding relevant and timely information on how to run a practice. A good example, though far from the only one, is the free Web site SearchMedica.com.

Decision Support Improves Diagnosis
Research shows that 15% of diagnoses are incorrect, costing millions of dollars and thousands of lives every year. Such levels can be attributed to the fact that for any primary care physician, there is simply too much to know and certainly too much to memorize. The nature of medical school training, financially driven time pressures on doctors, a fragmented health care system, and the ever-increasing volume of medical information are part of the problem. In addition, there are so many data available to physicians every day that it’s difficult for them to stay up to date on all new developments in medicine.

EMR Fosters Eye Clinic Growth
During our search for an electronic medical record (EMR) system, we stumbled across an anomaly—a solution that defied the lengthy timeline typically associated with adopting an EMR. Historically, the timeline required to install and use an EMR can delay the rewards a practice can realize from a fully digitized environment. Those rewards include growth, return on investment, increased productivity, and efficiency. The story of our success shows how the solution we selected for the Wheaton Eye Clinic shortened that timeline. In less than a year, the clinic achieved a fully digital environment, gained efficiencies, enhanced productivity, improved patient care, grew the practice, and increased revenue. Wheaton Eye Clinic is the largest private ophthalmology practice in Illinois. It has four satellite offices, 24 board-certified ophthalmologists, and seven licensed doctors of optometry. Founded more than 60 years ago, the clinic is a major provider of eye care services and a resource for referring physicians whose patients have eye care needs. We have about 115,000 clinic visits per year, and maintain some 180,000 active charts and another 180,000 inactive patient charts. In addition to our highly trained and experienced medical staff, Wheaton Eye also provides full vision correction services, contact lens specialists, and a designer eyewear studio.

Reports Show EMRs Improve Results
North Fulton Family Medicine, P.C., is a practice with 10 physicians and 10 physician assistants in Atlanta. The providers see more than 400 patients a day in four clinics. After exploring several electronic health record (EHR) systems, North Fulton Family Medicine selected HealthMatics EHR from Allscripts, in Chicago, and saved almost $254,000 for chart pulls per year.
In 2006, the Certification Commission for Healthcare Information Technology certified the HealthMatics EHR. CCHIT® certifies electronic health records and their networks, and is an independent, voluntary, private-sector initiative dedicated to accelerating the adoption of health information technology by creating an efficient, credible, and sustainable certification program. CCHIT recommends that physicians use its certified systems. CCHIT has collected case studies on physician groups that use these certified systems. North Fulton Family Medicine is featured in one of its case studies. Advanzed Health Care, PLC, a two-physician internal medicine practice in Arlington, Va., is another.

Speech Recognition Speeds Data Entry
For many physicians, electronic medical record (EMR) systems offer the potential to improve the quality of health care they deliver and reduce costs as well. However, many factors inhibit widespread adoption of EMRs, and one of the most significant roadblocks for physicians is the high installation and operating costs of these systems. EMR systems also can be inflexible and have other limitations that often prevent physicians from using them. Many physicians find that EMR systems are more effective with the help of enabling technologies. For the physicians at the Lifetime Health Medical Group, an example of enabling technology is speech recognition software to assist with transcription. We installed speech recognition technology shortly before implementing EMR systems in our offices in Buffalo and Rochester, N.Y., and experienced a smooth integration of the two technologies. The Rochester offices began EMR implementation in late 2006, while Buffalo began implementation early this year. In both places, speech recognition technology was implemented prior to EMR, and then integrated into the system. In both cases, the results were pleasantly surprising.