Practice experiences EMR implementation

March 1, 2005

One physician practice gains advantages through an EMR implementation

 Automated, integrated electronic medical records (EMR) and patient management systems provide a number of key benefits to doctors. The EMR portion of the system allows medical practices to schedule patient visits to the office, track a patient’s progress between the reception area, nurses’ station, and examination rooms, and maintain progress notes, clinical history, medication history, and complete lab and imaging results for each patient. Electronic medical records:

  • Improve data storage and retrieval of information about patients
  • Can be shared with other physicians, with staff within the practice and with hospitals
  • Help doctors send and receive interoffice communications to one another, to their staff and to hospitals
  • Help doctors send electronic prescriptions directly to pharmacies, reducing transmission errors and improving security
  • Are portable, allowing doctors to work on their patient records or billing at home, in the office or at the hospital

The Patient Management (PM) portion of the system provides complete billing information. You can create electronic claims directly from progress notes, submit them electronically to payors or clearing houses, and create patient statements. Patient Management software:

  • Integrates with the EMR system to streamline patient registration, patient information and patient billing
  • Lets you create and generate electronic claims and submit them electronically to clearing houses
  • Lets you receive electronic remittance advice (ERA) from clearing houses and auto-post payments
  • Lets you establish alerts that determine when collections are due

One internal-medicine practice in Long Island, N.Y., conducted research to determine which type of EMR system would be most efficient, looking on the Web and in Yahoo forums. The physician, Dr. Impellizeri, concluded that he needed a complete, unified, end-to-end EMR and PM system on a single machine and database, and it had to be efficient and inexpensive. 

Integrated systems save physical storage space by digitizing all patient records and eliminating the need for the physical storage of paper copies of patient documents. According to industry studies, it costs a medical practice approximately $1 every time a chart is physically pulled. Over the course of a year, that can add up to a significant amount of money. This number increases dramatically when a chart cannot be located or other issues intervene. For example, if a referring physician needs access to a patient’s records, that access can be facilitated by simply attaching the digital records to a secure e-mail. If physical records are being used, on the other hand, it can be cumbersome and expensive to fax or send the required pages. Incomplete medical records give an incomplete picture of a patient’s condition. An integrated EMR and PM system eliminates this worry. On top of that, the solution could cut down on at least one position/person per doctor, further streamlining the operation and saving money over time.

Dr. Impellizeri chose eClinicalWorks  after sampling a Web-based demo and asking in-depth questions about the way the application worked.

Key Questions to Ask EMR Vendors

  • Does your product use one database for EMR/PM?
  • Does your product have a unified user interface that provides complete access to both the EMR and PM portions under the same roof?
  • Does your product have a patient Web portal that allows patients to log into their own private medical information from the comfort of their own homes?
  • Does your product use the same, robust state-of-the-art client and server technology that eBay, Google, and Yahoo use?
  • Can your product’s server-based software be installed on Windows, Linux, or Macintosh?
  • Does your product connect directly to labs to send and receive results electronically?
  • Is your product mature? Reliable? Stable?  Does it have a proven track record?
  • Is your product economical? Can you purchase a single-doctor license for less than $10,000?

With just two days of training and an additional day for his biller, the practice went live with the eClinicalWorks system as the backbone. Since going live, the integrated, end-to-end EMR and PM system has simplified the day-to-day operation, from scheduling to billing.

“With the eClinicalWorks system, everything is at your fingertips,” said Dr. Impellizeri. “If a patient calls, I immediately have access to all of his or her past in-office encounters, their telephone encounters, labs and diagnostic tests and referrals. When physicians from other medical organizations in the area call and ask for a patient’s latest lab results, nobody on our staff has to go searching through the office to find the file. Everything is right there on the computer terminal.”

The system also affords Dr. Impellizeri the opportunity to use a TabletPC, which has freed him from his desk, allowing him to enter information into the system as he walks from one examination room to the next or anywhere else within the office, or even at home after work hours or at the hospital during rounds. Furthermore, the solution’s prescription feature delivers time-saving benefits, especially for patients who have more than one prescription, as the doctor can service these individuals with a few simple clicks of the mouse. The solution’s referral and recall feature also plays a role in protecting the practice from possible litigation by allowing the doctor to thoroughly document all aspects of each patient’s treatment, demonstrating that all proper medical channels were explored over the course of their relationship.