Overview:
With 21 years of experience practicing internal medicine, Dr. Anne Rose Eapen understands the value an EHR can bring to a small group practice. In 1990, she joined an internal medicine group that used an early EHR system. Despite the fact that it was a rudimentary system that required the maintenance of paper charts, even then she saw the potential benefits of health IT.
When Dr. Eapen and a partner started their own practice in 1994, they implemented a more fully functional system consistent with the current, conventional definition of an EHR. “At the time, we realized computers were the wave of the future. It was an opportune time to start fresh, abolish our use of paper records and implement an EHR,” Dr. Eapen said.
In January 2008, Dr. Eapen opened a solo primary care internal medicine practice, and considered the next step for her EHR as well. She had found the primary care template functionality on her previous EHR limited, difficult to customize, and not well integrated with other systems. This increased her need for support, which in her experience was costly and time consuming.
Outcome:
After a thorough review of several EHR products, Dr. Eapen chose e-MDs for its improved functionality, superior interface, better support, and lower costs compared with her previous system. Nonetheless, the switch took effort.
“The transition from one EHR to another was somewhat cumbersome in 2008 as we adopted our new system. Although it was easier than moving from paper charts to an EHR, a lot of data entry and scanning was needed,” she said.
Dr. Eapen particularly cites the training and support received from e-MDs and her vendor for her success. During the initial EHR launch, Eapen closed her practice for three days to allow for in-depth training on scheduling, charting and billing, and that level of support has continued as the system has evolved.
“Thanks to Sydian, e-MDs’ software support in the Northern Virginia area, and the periodic webinars and seminars they offer, we’re able to stay up to speed on key functionalities and keep the office open during important software updates,” Dr. Eapen said. “And, despite the hurdles we encountered during the EHR switch, I still believe that eliminating the previous EHR and implementing e-MDs was the right choice for my practice.”
Fast forward three years to 2011, and Dr. Eapen has successfully attested to EHR meaningful use. The process, however, had its own share of obstacles. As a result of the federal EHR incentives, e-MDs implemented new charting templates to capture data needed for meaningful use reporting. An initial attestation attempt in February indicated Dr. Eapen was not meeting meaningful use requirements for several clinical quality measures.
“This was because the new e-MDs templates required data from patient charts to be re-entered differently. I spent a lot of time generating reports and then analyzing them to prove that we were meeting the threshold compliance rate for meaningful use and CMS’ clinical quality measures,” she said.
In June, a second attestation attempt went more smoothly. Less than two months later, her Medicare incentive payment was in hand.
According to Dr. Eapen, she and her staff significantly modified their workflows to meet meaningful use criteria such as patient visit summaries. The group often spent early mornings and lunch breaks preparing notes for patient visits in an effort to prevent prolonged wait times for patients.
Lessons Learned:
For healthcare providers who are beginning EHR implementation or working towards meaningful use, Dr. Eapen’s advice is simple:
“It’s a matter of patience. Realize that the transition to a paperless system may be difficult. You will need extra time to accomplish your goals and competent EHR support staff to help with the process,” she said. “More importantly, find a product that has a proven track record. Proprietary software can be attractive because of low upfront costs, but it’s not your best option. It usually goes through extensive modifications and upgrades and has a high risk of being bought out, or worse, not being supported in the future due to limited use or market share.”
With her own implementation and meaningful use challenges behind her, Dr. Eapen believes the EHR has trans- formed her practice for the greater good.
“I’ve always said, and I still maintain, that I will never practice medicine without an EHR. It has dramatically changed the way in which we conduct office operations, improved the quality of life both inside and outside of the office, and truly impacted the care we provide to patients. We’re using it in a meaningful way and improving health outcomes for our community,” she said.