Health Information TechnologyPinnacle Family Medicine

• Michelle Eads, M.D.

• Practice Setting• Community solo practice• Family Medicine• One physician• Colorado Springs, Colorado

Motivation for HIT Investment

• Starting Solo Practice

• Prior group practice ran inefficient paper based office

• Wanted to improve workflow efficiency, patient communication, service and care

• Knew modern office embracing technology would become the norm

HIT Implementation

• Began simultaneously with starting practice in 2003 • Implemented integrated EMR/PMS prior to opening

Offered email communication at opening. Added website with secure online evisit capability 1/2007.

• Approximate total budget for the project was $23,000• Software $17,000• Hardware $5,000• Professional Services $300 for internet set up• Training included in software cost

• 6 people were involved from implementation to launch• 2 in office – physician owner and IT husband (who built

hardware)• 1 vendor on site to install software• 1 trainer on site• 2 internet installers on site

Office Efficiency• HIT investment has drastically improved office

efficiency• Workflow streamlined• No hunting for charts – are always available, and no need for a

filing clerk• Prescription refills are a snap• Signing off chartnotes, labs, etc. takes less time• Timely communication with patients

• Slight initial decline in efficiency upon initial implementation as adapt to new workflow, building patient charts

• Improved office efficiency has a profound effect on patients

• Answer their questions quickly• On-time appointments• Improved disease outcomes

Getting the Most out of Your Investment

• Continue to evaluate workflow and HIT options• New employees with computer experience get up to

speed quicker, but still take time and patience• Vendor offers online training sessions

Vendor Selection

• Knew I needed an integrated EHR and PMS, which quickly narrowed the field

• To find ‘the one’ I checked out the programs at national convention exhibits, visited sites with that software, and spoke with doctors using the product in a similar practice as mine

• Lessons learned and best practices• Do not rush your decision• Do not skimp on hardware• Prepare yourself and your staff for the transition• Understand your level of comfort and skill with IT• Follow the vendor’s specs for hardware• Double check verbal recommendations

Budget• Determined budget by anticipated length of service and

money saved by the product• Costs contained by IT savvy relative building computers• No overages• Vendor has fixed monthly charge, includes upgrades and

training (15-20% of initial investment/year)

Schedule• Set monthly and weekly goals and tasks over 4 month timeline

• Checked tasks and progress daily to keep the project on time

• Internet installation delay, de-bugging software to work together

• Four months was a short timeline

• Upgrades and associated training occur q1-2 yrs, takes ~1hr

General Improved Patient Outcomes

• HIT implementation improved patient outcomes• Track wellness and chronic dz data

• Know what to focus on for practice and individual patients

• Data instantly available for ER/specialist communication

• Improved pt treatment and outcomes

Condition Specific Improved Patient Outcomes• HIT can improve care for patients with a particular

condition• Registry to track data• Online pt survey to identify pts concerns and

chronic disease education/understanding gaps• Telephone and evisits improve access

• Benefits to the practice and patients• Smooth workflow, improve efficiency, reduce waste• Spend more time being a doctor for your patients• Improved accuracy of documentation, billing and

monitoring accounts receivable

Lessons Learned & Best Practices

• Determine what you want HIT to accomplish• Realize many tasks should change with HIT

implementation• Use resources available to you• Spend time observing the HIT in action to make sure it

meets your needs

Contact Information

www.PinnacleFamilyMedicine.com

drmichelleeads@alteer.com

Suggested Resources

www.centerforhit.org Center for Health IT at the AAFPHow We Improved Our Practice and Our Bottom Line With a New

EMR System. Bradley M Block, MD. Family Practice Management July/August 2008

www.aafp.org/fpm/20080700/25howw.htmlWhy I Love My EMR www.aafp.org/fpm/20021000/35whyi.html

Computers www.aafp.org/fpm/20020400/57howm.htmlThe EMR: Not Just a Computerized Chart www.aafp.org/fpm/20010100/08thee.htmlAvoiding Common Pitfalls in Selecting an EMRwww.aafp.org/fpm/classicstello.htmlSolo Physician’s Use of Virtual and Phone Visits, Same-Day Appointments, and Extended In-Person Visits Leads to High Patient Satisfaction and Improved Chronic Disease Outcomes. www.innovations.ahrq.gov/content.aspx?id=2196

HIT Suite

• Alteer - EMR/PMS www.alteer.com• Medfusion - website with evisit capability

www.medfusion.net• UpToDate – EBM resource www.uptodate.com• Epocrates – medication and formulary info

www.epocrates.com• Hows Your Health - patient survey

www.howsyourhealth.com• LogMeIn iPhone application to access server• Microsoft Excel spreadsheet for registry• Laptop with wireless internet card for out of office access

Outcomes example using HIT Enhanced PCCC

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1stYear

2ndYear

3rdYear

4thYear

5thYear

6thYear

HTN US

HTN

DM <7

DM <6.5

Chol

% Having a PCP 97.47

% Having Perfect Care 77.22

% Having Very Easy Access 72.15

% Having Confidence in self-management

69.23

% Seldom Wasted Time 97.44

% Get Exact Care Needed 67.95