August 2008 eFeature
Instantaneous Access
A multi-office practice deploys a hybrid EMR, offering secure dissemination of patient information among locations.
By Robert Hendler
A satellite office provides a multitude of benefits to a practice and its patients. However, the logistical challenge of managing paper charts between locations can open a Pandora’s Box that challenges both patient care and practice uniformity; such was the case with Cardiac Specialists, P.C.
With bricks and mortar firmly in place, our new satellite office gave patients the flexibility to choose their preferred location. At times, we were unable to coordinate paper-chart data between locations, which overshadowed many of the benefits provided by our new facility. With 20,000 active and inactive charts residing within our primary office and no technology in place to synchronize patient information (e.g., visitation notes, test and prescription data) between facilities, both the practice and patient suffered delays.
Additionally, because the charts resided within our primary office, physician access to patient information was impeded. In an effort to compensate, staff members would fax patient records between locations, or nurses would read patient information to a physician over the telephone. Occasionally, these communication methods could not keep up with requirements of a group whose specialty by its very nature demanded instantaneous access to patient information in its entirety. In addition, there were common paper-chart inefficiencies — misfiled, incomplete and duplicate charts — that reduced the efficiency of our practice.
Tackling the Challenge
Recognizing that our practice could not continue along its current course, we began our search for a solution. With multiple technological products and vendors from which to choose, we decided to conduct a thorough assessment of our current challenges, potential needs and available resources. Our goal was to identify the optimal technological solution that would address our needs, position us for anticipated growth and give us a competitive advantage.
Although our knowledge of the health IT industry was limited, several of our physicians were tech savvy. We began by researching traditional electronic medical records (EMR) systems and found them to be cumbersome and difficult to learn, use and implement, and expensive and risky when looked at as an investment. We knew several practices that abandoned their EMR initiatives after making considerable investments. Additionally, the extensive learning curve required to reach maximum efficiency further contributed to the already high cost of EMRs. We could not afford to take this risk.
After comparing several EMRs against our practice’s needs, we concluded that the initial purchase costs, combined with the resulting loss in productivity during the implementation process, would create an unfavorable return on our investment. An EMR would not solve our chart related problems; it would contribute to them.
Then, during a Connecticut conference, we were introduced to the concept of the hybrid EMR. A hybrid EMR takes the flexibility and customizability of a document management solution and enhances it with robust database/data entry features that would ultimately allow us to successfully participate in pay-for-performance programs, conduct research, and pro-actively anticipate and manage patient care.
A hybrid EMR takes the flexibility and customizability of a document management solution and enhances it with robust database/data entry features that would ultimately allow us to successfully participate in pay-for-performance programs, conduct research, and pro-actively anticipate and manage patient care.
Solution Results
After four years of embracing SRS Clinical Manager, a hybrid EMR, we have fulfilled every one of our practice goals. The hybrid EMR solution was one-third the cost of a traditional EMR and allowed us to digitize all of our patient records, quickly implement the solution, and avoid adversely affecting physician productivity. We’ve never had to alter the way our physicians practice medicine; it has become an extension of our physicians. Additionally, the hybrid EMR allowed us not only to share patient-chart content with our satellite offices, but also to provide our physicians access to their charts anywhere at anytime.
We reclaimed internal real estate by eliminating our chart rooms. We eliminated 3.5 full-time employees, which results in a savings of $122,500 annually. Even with factoring in the cost of the deployment, we still came out ahead. We reduced physician workload time after hours. Since information now flows rapidly throughout our practices, our patient response time has decreased, resulting in superior patient follow-up. We saved thousands of dollars of inefficient seepage while consistently boosting office productivity. Most importantly, we have enjoyed operational advantages and efficient workflows.
Robert Hendler, FACMPE, is the practice administrator for Cardiac Specialists, P.C. in Fairfield, Conn. Contact him at rh@cardiacspecialists.com.
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