Primaris Press Release
April 2006 Originally published in the Journal of the Greene County Medical Society |
Contact: Matt Heger |
Paper's Prognosis: EMR in a Small Town Solo Practice
by Matt Heger, Primaris
When Scott Turner, MD, started his residency in the late 1980s, it was a paper world. Charts, prescriptions and appointments required ink on pressed, pulped wood. But when it came to establishing his solo practice a few years ago, Turner's business plan called for a different approach. In order to keep the absolute lowest overhead possible, he wanted to run the office with minimal staff; simply an office manager position filled by his wife. Not long ago, this would have been impossible.
Enter electronic medical records. Setting up shop in Osceola, Turner implemented an EMR before opening his doors. The system makes it possible for him to keep his overhead at or below 40%, far below the 50 to 55% in many paper practices.
“Some people think ‘Oh, it's a cute toy!' But implementing an EMR is much more than dropping computers in front of everybody,” Turner said. “It can and will change the way you do business.”
Starting his practice from scratch with an EMR already in place saved Turner many major steps. For anyone taking the EMR plunge, Primaris offers primary care physicians with no-cost assistance through a program funded by the Centers for Medicare & Medicaid Services. The program is called Doctor's Office Quality-Information Technology (DOQ-IT) and it offers support going electronic, from analyzing needs to maximizing efficient results quickly.
Even with his clean slate, Turner said that it would have been helpful to receive many of the services offered by DOQ-IT. He said that learning about vendors through Web-Ex presentations, as well as in-office visits with doctors who already have EMRs in place would have been beneficial.
Though he never had to convert systems, he still has to deal with converting reams of paper – especially from other offices – into digital form. But he doesn't keep any loose-leaf lying around. Instead, he scans the documents and attaches them to his patient's chart.
“When I started, I didn't realize all of the options that I had for placing information into an EMR,” Turner said. For example, optical character recognition (OCR ) software, which can translate a scanned image into words and sentences, was a major boost.
When getting a new EMR , one of the most important tasks is to research available features which meet your office needs. In choosing the best system, Turner advises to look for two things: access to information and presentation of that information.
Access to information is what gives EMRs the best advantage over paper. “You can ask me for any piece of information on any patient I have, I can get that in less than 10 seconds. When did John Smith have his last colonoscopy? Click, click, and it's there. Imagine how long that takes for paper.”
A good EMR gives almost instant access information. Going a step further, a really good EMR presents the information in an efficient and useful manner. Turner finds that, with everything from X-rays to lab results to medicines listed in his files, having it in a format that is easy to read is extremely important.
Other features to look for include electronic prescriptions, which faxes prescriptions to pharmacies without you ever touching paper. Many EMRs offer inquiries that can be used in the event of a medication recall. Rather than relying on the pharmacies to contact patients, you can quickly pull up a list of all of your patients on any particular drug.
Turner's EMR also includes an online “knowledge bank” that lets him download disease- and complaint-specific visit forms. These provide him with useful exam prompts and questions to ask during interviews.
Practice size should not be a hurdle to utilizing an EMR. In fact, Turner's system is what keeps him running lean and turning a better profit. The list of pointers for implementing a system is endless, but here are a few of the most important which DOQ-IT can help with.
- Plan ahead
You can't predict every bump, snag or pitfall that will crop up while converting systems. However, careful planning can alleviate many problems and ease the transition to an EMR .
- Don't carry over poor workflows
“If all you are going to do is convert a paper office into an electronic office, and you don't fix poor paper workflows, then you end up with poor electronic workflows. You've wasted your time, effort and a considerable amount of money,” Turner said.
- Know what you need before researching products
Often, physicians are approached by vendors, who show them all of the bells and whistles of their particular product. But Turner warned that this approach is somewhat backwards. “It's a bit like walking onto a car lot and letting someone sell you a Porsche when what you need is a pickup,” he said.
To request an application for the DOQ-IT program, send an e-mail to ehr@primaris.org or visit www.primaris.org/doq-it/.*
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*Original article linked to www.primaris.org/doqit-overview.asp. This page was updated to reference current Web navigation.
MO-06-15-DOQ This material was prepared by Primaris under contract with the Centers for Medicare & Medicaid Services (CMS). The contents presented do not necessarily reflect CMS policy.