EHRs Continued from page 18
The paper costs alone are signifi cant. Each provider sched- ules 25 appointments a day on average, or 925 appointments total daily for the practice. Before the EHR system, each ap- pointment created at least six sheets of paper for the patient’s chart, which translates to 5,550 sheets a day and more than 1.5 million sheets a year. What’s more, the practice receives 30 requests a day for medical records and sends about 35 requests per day to other locations. With the EHR, the practice has eliminated the need to fax 975 sheets per day, or 19,500 sheets a month, just for the clini- cal staff. The billing staff used much more paper. Combined, the annual paper expense savings equal about $62,272. Based on our current growth, the practice estimates an annual labor and paper cost savings of $2.9 million by 2013. However, the benefi ts have extended to more than just expenses. Through a partnership with its IT vendor, the practice now runs reports in its PM system that were nearly impossible with paper records. It can instantly view which higher-reimbursement procedures have not been paid, for instance, or which health plans are not paying according to the fee schedule, or how long claims have been outstanding. By following up on the claims shown in these reports, the practice has increased its revenue by 26 percent, decreased outstanding A/R by 76 days and overturned hundreds of deni- als. These claims account for millions of dollars the practice did not collect before adopting the NextGen Ambulatory EHR and NextGen Practice Management systems.
Automating functions ensures better patient care On the patient-care side, the ability for multiple staff members to work in a patient’s chart is now a reality. The lab department can simultaneously input test results while the triage department can log a phone call and the billing team can access the record to fi nd documentation for a claim ap- peal. It all adds up to much smoother operational, fi scal and patient-care processes.
One example is the system’s automated recall feature, which has been invaluable to the practice. This function helps patients follow their health/pregnancy-management plans by reminding clinical and front-offi ce staff about follow-up ap- pointments, treatments and testing. After a visit, for instance, a provider’s note in the EHR to follow up with the patient in three months synchs with the PM system to be scheduled before checkout. Nearly three months later, the recall system will alert front-offi ce staff members to remind the patient of the appointment. Soon, the practice will upgrade its telephone system so appointment reminders will be automatic.
Another feature that has improved patient care is the abil- ity to upload ultrasound images into patients’ charts almost immediately after images are captured. After an ultrasound study is completed, the equipment burns the images onto a DVD, and that information is then uploaded into the patient’s EHR. (The EHR actually is capable of capturing images directly
from the ultrasound device, which would eliminate the need for a DVD. However, the ultrasound manufacturer charges a signifi cant fee to enable that feature, so the practice is still contemplating the upgrade.) Regardless, an ultrasound and follow-up visit with a provider on the same day keeps the practice’s anxious obstetric patients and nervous gynecological patients from having to return for ultrasound results. This way, any immediate questions are answered and they can receive appropriate and complete fol- low up. Likewise, when obstetric patients visit the hospital, lab results and ultrasound images are immediately accessible electronically. The practice’s doctors can log in and access the patients’ charts as if they were in the offi ce and see the most current test and medication data, which helps avoid delays, complications and potentially harmful duplicative testing.
New effi ciencies, new patients, bright future Prior to adopting its EHR, trying to quantify return on in- vestment (ROI) was diffi cult at best. Like any growing practice, though, it was important to be able to track how new patients came to hear about Drs. Goodman & Partridge. While operational and fi nancial effi ciencies are to be ex- pected when automating a practice’s systems, the ability to report on marketing results was an unexpected, but welcome, addition. The system now allows the practice to collect data from patients, such as how they heard about the practice and what insurance they have, and track this data to determine the most effi cient way to spend marketing dollars. Here is an example: In May 2011, the practice determined most new patients arrived through PPO/HMO network di- rectories and physician referrals. However, 153 new patients saw the offi ce while driving by, 17 new patients came from billboard advertising, fi ve from the Yellow Pages ads, two from the practice’s Adopt-a-Highway signs, two from magazine ads, one from a newspaper ad and 117 from the Internet. Based on this type of reporting, aside from health plan networks and physician referrals, it is clear that the practice’s website and its search engine accessibility are crucial to its marketing efforts.
The practice also tracks when established patients rec- ommend the practice to new patients. When they do, the established patient receives a reward, such as a gift certifi cate for a massage. This incentive program is also managed within our automated systems and helps encourage new patient visits while maintaining established patient awareness and satisfac- tion. Without the ability to track this data, however, it would be extremely diffi cult, if not impossible, to track marketing and patient incentive efforts with this kind of precision. In fact, it is pretty safe to say that Drs. Goodman &
Partridge, OB/GYN could not be the practice it is today without the capabilities of its EHR system. Eliminating the hassles of storing, handling and sharing paper has saved it millions of dollars, but the benefi ts extend to more than just digitization.
HMT HEALTH MANAGEMENT TECHNOLOGY February 2012 23