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Case Study

MIT MedicalCambridge, MA

“The best benefit of all is that MIT Medical has become a group practice rather than a gathering of physicians.”

Tom Goodwin Clinical Information Systems Coordinator MIT Medical

Allscripts Enterprise (formerly TouchWorks®)

BACKGROUND

Massachusetts Institute of Technology Medical (MIT Medical) is a large multi-specialty group practice and mental health provider in Cambridge with 74 physicians, as well as nurse practitioners, social workers, psychologists and many other health professionals.

Designed specifically to meet the needs of the entire MIT community, MIT Medical is more than a traditional university student health service. It is a complete healthcare center serving the health and wellness needs of students, employees and retirees of MIT, Whitehead, Draper and their families. And it can provide many health care services right on campus.

Offering comprehensive care across the age continuum, from preconception to pediatrics to geriatrics, MIT Medical provides access to a broad range of clinical services and medical specialties delivered by highly qualified health care professionals. The practice delivers care to more than 20,000 patients, with 130,000 visits per year.

OPPORTUNITY

A decade ago, MIT was struggling with how to provide the best medical care to a large student and faculty population treated by multiple physicians. Patient safety, confidentiality and access were challenging given MIT’s inefficient paper-based processes for storing and accessing medical records.

Because it was an all-paper office, physicians and staff often had to wait for charts or spend valuable time trying to locate patient information. Dictated documents and lab results often took days to reach the patient’s chart. Sometimes physicians were forced to see patients without current clinical information because of this slow paper process.

This led to frequent – sometimes potentially dangerous – inefficiencies. These paper-driven inefficiencies created added expense for the practice. More importantly, return telephone calls to patients were sometimes delayed, test results were sometimes unavailable, notes were occasionally missing, and prescriptions weren’t renewed on a timely basis. Patient follow up time was longer than the Medical Department wanted.

MIT knew EHR was the road they had to take. As the team at MIT considered how to pursue this path, they set specific goals to guide their search for a technology partner:

Improve care

Control costs

Increase productivity

Enhance clinician satisfaction

Meet compliance guidelines

Interface with IDX practice management system

RESULTS

Financial Results

Reduction of 4.5 FTEs in medical records

68 percent reduction in total chart pulls in the early years of implementation

Remaining paper charts have been scanned and eliminated

Dictation costs reduced by more than half - from $300,000 to $140,000

85% of the notes created in Enterprise are dictation “free”

Savings in purchasing forms

Credit from medical liability insurance carrier

Improved HIPAA compliance

Improved JCAHO compliance

Cost savings for health plan, pharmacy and patient due to formulary prompts

Case Study

MIT Medical

RESULTS

“We have evolved from a clinical repository system, to a hybrid of paper and electronic, to now all electronic,” said Goodwin. “EHR is now a part of our day-to-day work as essential as electricity, water, or the telephone.”

MIT went live with the web-based version of the Allscripts solution in 2003. Providers can now leave the office on time and finish documenting patient encounters and follow up online, including from the comfort of their homes. This has led to greater job satisfaction from all the practice’s physicians.

MIT physicians can now access a patient’s entire medical record immediately from anywhere, update the chart on the spot, review current prescribed pharmaceuticals, check for standard drug interactions or lab results, and send electronic prescriptions to the patient’s pharmacy.

In addition to improving the quality of experiences for providers and patients, the entire practice appreciates the cost savings generated by Allscripts. Immediate savings included transcription and dictation costs. Thanks to EHR, transcription turn-around time has been reduced by an average of 34 percent and dictation costs have been reduced by more than half. For instance, dictation costs were $300,000 per year in 2003, and are now running $140,000 per year based on 2009 to date.

In Medical Records, MIT has been able to reduce personnel by 4.5 FTEs through attrition, saving approximately $180,000 per year.

Finally, by eliminating the creation of new paper charts for MIT’s 1,800 new annual patients – who now have their information entered directly into the EHR – Allscripts saves $11,700 in labor and supplies annually.

LOOKING AHEAD

“We’re still enthusiastic after 10 years,” said Goodwin. “We’ve had tremendous uptime, all of our physicians are now fully using EHR, and we look forward to even more benefits as additional processes are streamlined.”

MIT Medical is looking ahead to interfacing the few remaining diagnostic tests that have yet to be interfaced and enhancing disease management capabilities. Additional time and cost savings from EHR use in mental health services are expected as well.

“Without a visionary and stable partner like Allscripts, having EHR so deeply ingrained in our culture now would not have been possible,” said Goodwin. “EHR is definitely needed to play in the big leagues.”

RESULTS (Continued)

Clinical Results:

Instant access to the clinical record when and where it’s needed

Enhanced patient safety via automated decision-making and drug/allergy Alerts

Electronic results from labs and X-ray interfaced with patient record

More efficient processes for generating referrals and correspondence

Electronic prescribing and streamlined Rx refills

Time savings for ancillary staff-Expanded clinical role -Refill service

Improved follow-through with patients, ensuring care-plan adherence

Faster, easier communication between physicians and support staff, and with patients

Better preventative healthcare and disease management

Improved physician satisfaction

Improved patient satisfaction

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