Electronic Health Records - Reality vs. Fantasy
by, 09-24-2010 at 08:00 AM (2458 Views)
Meadowbrook Neurology Group seeks to provide the highest quality of neurological care for its patients. By combining clinical experience with the latest in diagnostic techniques and therapeutic interventions, Meadowbrook Neurology Group seeks to not only treat a diagnosis but also the individual, as well as the family, who may also be affected by the diagnosis. Each patient has their own problems and concerns as well as their own unique paper chart. The paper charts began to pile up at an alarming rate. To provide the quality of care that Meadowbrook expects from itself, it needed to find a solution which eliminated the paper process and created a more efficient way of dealing with patients charts. It was important to choose a solution that would qualify for the $44,000 per physician provided by the government if they met the terms for “meaningful use”. As the Practice Manager, Sherry DeDiminico knew that the best solution was to move to an electronic medical record system.
Meadowbrook Neurology Group had been dealing with an all paper system. To gain the efficiencies in their practice that would help them reduce costs as well as meet the guidelines for meaningful use, Sherry had to implement a system that would provide for a patient/physician portal, e-prescribing and other components. Since they have three offices, their paper system required paper charts for every patient. Since all of the information was in writing on the charts, the charts had to be carried between all three of the offices. Practice manager Sherry DeDiMinico said, “The paper charts are only available to one person at a time and this was a real problem because they had to be shared between three offices. The charts also had to be filed for lab reports, phone messages, and for the billing process which occasionally caused the charts to get buried beneath tons of paperwork.”
Meadowbrook Neurology Group needed a solution that would help them stop relying heavily on paper products. Meadowbrook’s first solution was using desktop computers in every physician’s office. “A lot of market forces were pushing us towards an all electronic system. We tried PCs but the doctors all found them very intrusive to the doctor-patient relationship. They were forced to turn away from patients in order to enter data,” Sherry explained.All of the medical charts had to be carried by hand between the offices because the doctors’ notes could not be transferred electronically. Meadowbrook saw this as an extremely inefficient way to do business. They needed a way to integrate their paper charts into a new EMR system and find a solution that could make their entire process more efficient.
The doctors at Meadowbrook would rather take handwritten notes than type into a computer. For Meadowbrook, this meant PCs were not the answer. They needed something that could not only store and transfer data easily, but a solution that could be mobile enough for their doctors to keep all their attention on patients. Then, John Hill introduced Meadowbrook Neurology Group to the Tablet PC.
“We were a little worried at first because some of our physicians were a little less tech savvy then others, but the tablets gave our doctors the ability to handwrite their notes directly onto the tablet which was really the biggest draw for us,” Sherry said. “Ultimately, the new legislation is a good thing. Physicians have a lot of inertia when it comes to technology and they need to be pushed. The way that the government is phasing in the program is realistic and it is pushing doctors into areas they aren’t familiar with.”
Tablet computers can now be seen throughout the Meadowbrook Neurology group. Medical assistants now take the tablets into every exam room and use eClinicalWorks to record responses and vital signs. This allows important information to be available to the physician immediately which has improved overall efficiency.
Because they doctors are also using Dragon Naturally Speaking Medical, Sherry was able to reduce staff by one transcriptionist and eliminate $800/month in outsourced transcription costs.“It took a little time, but all of our doctors transitioned to the tablets and I don’t think any of them would go back to the old way of doing things. They can take their tablets home with them and it allows them to have any medical record they would ever need while they are on call,” Sherry went on to explain, “It has improved our documentation and gives us a big advantage while using the EMR to record every encounter with a patient, and our neurologists draw pictures as part of an exam which they can do it directly onto their tablet!”
The tablets have not only proven to be very efficient, but they are also very durable and easy to sanitize. “We have had tablets for more than a year and a half and we’ve had no issues with durability,” Sherry said.
Meadowbrook Neurology Group can now easily transfer data between their three offices without having to run between them. Doctors now have the ability to take handwritten notes and draw pictures directly on the tablet. Doctors can also sign off on documents directly on their tablets. Sherry said, “The tablets have begun to save us a lot of money on paper products because we don’t need to use them anymore! I believe overall, the tablets have greatly improved the efficiency in our offices.”
While they have made great strides over the past couple months, Sherry still has a lot of work to do. “To qualify for meaningful use reimbursement, we have to implement e-prescribing. The doctors love this and it is easy to do with the tablets but Schedule 3-5 drugs like the ones they doctors prescribe for pain management aren’t allowed to be sent electronically. This puts us in a difficult position and the legislators need to fix this.”
Sherry also related that they are waiting in line to have their patient/physician portal installed. While they look forward to this from the perspective of being able to share e-health records, they have been approached by some patients who say they do not want their information online.
While technology can solve a lot of problems and can improve processes, especially those that involve paper records, there are still a lot of forces slowing the adoption of EMR solutions. Practices like Meadowbrook Neurology faces a lot of hurdles before they get to the desired end result of a secure, electronic health record that reduces costs and improves patient care.