PRACTICE
MANAGEMENT

Turn your technology dream into a practice reality

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by William H. Constad, M.D.

After years of touting technology, my vision is finally becoming a reality.

About three years after implementing an electronic medical record (EMR) system and practice management system, our practice is now working with about 3,500 paperless patients and should soon get close to 5,000. And, we are migrating all of our other paper patient charts to the electronic environment as well. As a result, our practice is using information technology to save time, reduce errors, improve efficiency, and, most importantly, provide better care to our patients.

Searching for the right solution

Our practice first started toward a paperless office in 1995 when we implemented an electronic medical record system. The EMR helped to automate many processes, but lacked the functionality necessary for continued business growth.

Also, in 1999, the vendor that provided this technology decided not to support a Windows-based system. That's when I decided that our practice needed a technology platform that would truly make good on all of technology's promises. We identified the following criteria that this platform had to meet:

· Flexibility. All of our doctors practice medicine with their own unique style, so we needed an electronic medical record system that would allow for our differences. A one-size-fits-all solution wasn't an option.

· Feature-rich clinical and administrative systems. Because physician practices need to offer great care while running a viable business, we needed a platform that offered strong functions on both the administrative and clinical sides of medical practice.

· Integration. We needed a platform that would enable us to integrate back-office (patient care, medical records) and front office (billing, recalls, appointment scheduling) information. The platform also needed to connect with other information system and technologies.

With these criteria in mind, we ultimately selected an EMR and practice management system from NextGen Healthcare Information Systems.

The NextGen EMR enables individual physicians to establish their own templates - virtually mirroring how they take notes on paper. As such, the transition to an electronic medical environment is much smoother for these physicians, some of whom might be apt to shun technology all together.

In addition, the EMR and practice management systems offer strong functionality, the crucial nuts-and-bolts features that we need in our day-to-day operations. What' s more, both systems can seamlessly accept input from other information systems as well as medical devices, thereby increasing their value even more.

Real results

Our practice has realized quite a few financial and operational benefits since implementing both systems in 2000.

On the administrative side, the practice management system is so intuitive and easy to use that we have decreased our time spent on claims management by about 30%. While our practice has always prided itself on sending out clean claims, we are now able to send out such claims more efficiently. Checking on denied claims is easier, too.

For instance, office staff can determine whether or not a denial is justified by simply opening the patient's chart on a computer screen, instead of having to dig through piles of paper charts.

Because of the integration between both systems, we are able to capture a greater percentage of clinical charges. With paper, it was easy to provide a service and then forget to adequately document that service for billing purposes. The practice management system ensures that all services are documented and passed on for billing.

We're making great strides on the clinical side as well. Because more of our records are moving from paper to electronic, doctors can quickly access patient information right in the exam room. Plus, we are able to use the electronic templates to quickly input our clinical notes during patient visits.

In addition, the comprehensive EMR database enables our physicians to communicate with other physicians outside the practice. For example, instead of having to dictate a letter when referring a patient to another physician, our physicians can simply create a letter by transferring information from a patient's electronic chart into a Microsoft Word document.

The EMR also allows me to automatically fax a prescription request to another physician or order contact lenses for a patient right from the exam room. These functions alone save me one or two hours per week.

But the clinical advantages don't stop with mere process improvements. Just having access to electronic records is an advantage, especially as it relates to patient care. When working with paper patient charts - our practice previously had to manage about 20,000 of them - there were times when charts could not be found. As a result, patients had to be cared for without complete medical information at hand, a practice that in some situations could have made care less than optimal.

With the EMR, we are now able to access better, more complete information for our patients. For instance, actual readings from testing equipment such as retinal cameras and visual field machines can be integrated right into the electronic medical record - giving our physicians a complete rundown of a patient's medical history and current health status.

Most importantly, however, the EMR helps us proactively provide better care for our patients. The EMR automatically warns physicians of a patient's allergies, thereby reducing the chance of a medical error occurring.

Plus, the very fact that all notes and prescriptions are entered electronically makes it more likely that the information is accurate.

Patients and pharmacists alike particularly appreciate the fact that their prescription forms are printed and much easier to read.

Finally, being able to access patient charts at home via a Web browser also helps to improve the care and service we provide our patients. If I receive a call over the weekend from the emergency room, for example, I can easily access a patient's medical history and relay the clinical information to the ER staff.

This increased access to information naturally helps to improve the care that the patients receive. And, ultimately, improving patient care is our No. 1 goal.