Michigan Vascular
With 9 vascular surgeons and 74 employees in three locations, this practice's quick adoption of SRS helped them grow their practice, and their revenue.
As our practice grew, the movement of paper charts between desks or departments was drowning us. Searching for a chart led to delays, frustration, increased ambient noise, and inefficiency. When referring physicians called with a question, at least one staff member (oftentimes more) would leave their desk and scurry around trying to find the chart so the vascular physician in the office had enough data to provide answers.
You can imagine how, in a paper-based office with nine physicians, charts end up sitting on doctors’ desks waiting for messages to be returned or lab data to be reviewed. Stacks of charts will be sitting on billing staff desks awaiting charge entry and additional stacks will be in the areas of chart preparation or surgical scheduling. We needed a solution. We looked at various EMR products, most of which are costly and required a physician’s commitment to many hours of set-up time in designing the templates. In addition, not all of the members of our group were excited about the dramatic change which would occur in their method of charting.
One product rose to the top as a solution. We chose a hybrid-EMR software scanning system for putting existing charts into electronic format. Every piece of paper in the chart is scanned into the patient’s electronic chart. The electronic chart has tabs, similar to our previous paper chart. Chart notes go in one tab, while correspondence goes in another, and abdominal ultrasounds in yet another. All of the forms we were previously using were simply re-created to include a barcode. This enabled physicians to continue to see patients the same way. When a patient presents to the office, any new records or blank forms (such as our physical exam form) are placed on a clip board. The physician can see all previous records on computer monitors, both in his chart room and in the treatment rooms. When he examines the patient, he can hand write his notes on the exam form, just like before. For physicians who find it hard to change, this option can accomodate “old ways of doing things.” When the patient returns to the front desk for check-out, all the new forms from the clipboard are placed in the scanner. With the push of a button, the barcode reveals which chart and which tab in that chart this document belongs. It is inserted instantly and available for viewing to all members of the staff.
We have also created a few of what they call ‘living documents.’ These are basically Excel spreadsheets which can also reside in chart tabs. They allow us to collect data, add to it, or make changes as necessary. For example, we have a procedure list created as a living document. As the patient has additional surgical procedures, we can add them to cumulative list.
Now there is no lost time searching for charts. When a call comes into the office for any information, either from a patient or a referring physician, the patient’s chart and lab data can be accessed from any computer terminal in the office. This has led to quicker response time and, obviously, better service.
Secure internet access at our homes even allows for review of records on a 24/7 basis when patients or physicians call after hours. The upcoming surgical schedule and work assignments for our entire team are all available on-line in real time. The electronic format allows multiple people to view the same patient record simultaneously, thereby increasing efficiency across all departments in the office. Because charts no longer have to be pulled or chased down, we no longer employ additional staff to search for charts and re-file them for the different departments in the office.
Another important benefit of an electronic record is our ability to instantly have at our disposal a vast database of all non-invasive vascular studies performed in our vascular lab, including our main office, McLaren, and Hurley labs. Often when we are asked to see a patient for the first time, we find they are not truly new to our office. The patient’s physician may have ordered a non-invasive examination in the past, which we are now able to access and use in the patient’s evaluation and treatment plan. This not only gives us an indication of the progression of a given vascular condition, it also gives us a reference point to judge the severity of the problem. No longer are tests stored in the basement because we haven’t seen the patient in five years. That information is now readily available at the click of a button.
As we go to press we are anticipating upgrading and extending our system. We will be adding an Rx module which will allow us to improve patient safety by having a prescription tracking system. The next version will also provide methods for our practice to collect better outcomes data and to increase communication. As the government and public continue to demand better electronic and technological availability of personal health data, we believe that advancing in this area keeps our practice ‘state-of-the-art’ into the future.
Our hope is to encourage you. We were apprehensive about taking this step. There was an adjustment period. However, the system is user-friendly enough that it didn’t take much time to adapt. It has been most interesting to watch how different generations of physicians and staff have all embraced our EMR System and adapted it to their own needs. Despite some minimal, initial anxiety on some physicians’ parts, there has been a remarkable adaptation of this technology within our group. We have had a positive experience in taking the techno step.
Our decision included viewing several products and watching demos. We contacted numerous practices, visited user sites, and interviewed users in order to gather information. So, if you are considering taking the next step, we would encourage you to do so.
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