e-MDs

Solo Family Practitioner Uses EMR To Acheive Level 3 Medical Home Certification
(Emmanuel St. Louis, MD; Long Island, NY)

	CLINIC PROFILE
	* Family Practice
	* 1 Provider
	* 4,500 Visits Per Year
	e-MDs PRODUCTS
	* e-MDs Solution Series™
	* Sunrise Medical Structured Lab Results Interface    Laboratory Interface
	PROJECT GOALS
	* Improve Access To Patient Charts
	* Increase Legibility and Complettion of Visit Notes
	* Improve Documentation Speed and Billing   Efficiency
	* Support Participation In State and National   Quality Initiatives
	RESULTS
	* Instantaneous access To Patient Charts From   Practice, Home and Hospital
	* Streamlined Documentation and Billing   Processes
	* Significant Increase In Patient Visit Volume To   35 to 40 Patients/Day
	* Greater Than 35% Increase In Practice Revenue
	* Acheived Level 3 NCQA Certification For   Physician Practice Connections® - Medical Home™

Dr. Emmanuel St. Louis is a solo family physician that splits his time between a busy Long Island practice and his position as vice-chairman of the family practice department at Brooklyn Hospital. After ten years in practice using paper charts, he was well aware of their limitations and was attracted to the promise of electronic health records. “We were interested in EHRs because we knew that it would be a more complete and legible record,” recalled Dr. St. Louis, “and that it would allow us to do a better job of patient care—particularly for patients with chronic conditions, like diabetes.”

After an extensive survey of EHRs at the American Academy of Family Practice’s Annual Scientific Assembly, Dr. St. Louis chose e-MDs for his practice. “We felt that e-MDs Solution Series™ was more user friendly than the other systems we looked at, while still giving us all the features that we were looking for,” said Dr. St. Louis. “We are very happy that we made that choice.”

A Successful Deployment

Despite a small staff and a part-time practice, with his wife Kathie functioning as office manager, Dr. St. Louis successfully deployed e-MDs into his daily clinic workflow. Their hard work paid off, particularly in streamlining documentation and billing. “Before e-MDs, we struggled with incomplete charts, unbilled items and a mess of handwritten notes that had to be reconciled into a formal claim. This was very time consuming,” recalls office manager, Kathie St. Louis. “Now since documentation is much easier for Dr. St. Louis, he is able to complete his notes much quicker—which improves our billing operation.” This change has shown up on the bottom line, allowing the practice to significantly increase patient volume (now at 35 to 40 patients a day) and increase practice revenue by over 35%.

Achieving Medical Home

With an EHR in place, Dr. St. Louis was in a position to consider new approaches to managing care—such as the Medical Home. Prompted by a local payor that was initiating a Medical Home project with practices in the area, Dr. St. Louis decided to take the plunge.

The transition to a Medical Home model required a different approach. “The Medical Home involves a more pro-active method of patient care,” noted St. Louis. “The practice takes a greater responsibility for helping ensure patients are staying on track in managing their illnesses—which is particularly crucial for patients with chronic disease.”

The Medical Home approach was ideal for the practice’s location in Nassau County, which has a very high incidence of diabetes, hypertension and hyperlipidemia. “Over 75% of our patients suffer from one of these conditions”, said Dr. St. Louis.

Using Tools within e-MDs

e-MDs has played a crucial role in initatives giving Dr. St. Louis the tools to support the Medical Home. Using e-MDs reporting capabilities the practice was able to quickly identify patients with chronic conditions, which then formed the basis for an internal disease registry to help proactively manage these patients.

“You have all the information that pertains to a particular condition right at your fingertips. ” -Dr. Emmanuel St. Louis

e-MDs integrated scheduler also provided assistance, by flagging overdue health maintenance items when patients requested appointments, allowing the scheduling of additional time to complete these tasks and optimizing the provider’s schedule. The scheduling system also provides reports on missed appointments for patients, allowing the practice to target specific patients that may be having trouble complying with care plans.

Point of care interaction is also crucial. Dr. St. Louis notes, “It is critical to establish a good relationship with the patient. With e-MDs, since it is easier and quicker to document I have more time to focus on the exam and communicating with the patient.”

Dr. St. Louis also notes that e-MDs documentation and graphing tools help engage the patient in their care—a critical component of the medical home. “e-MDs EHR helps the patients participate with you. I can quickly show them care guidelines and graphs of how they are doing on their blood pressure or blood sugar so they can easily see their results, which really helps with compliance.”

Patient education is also a significant aspect of the practice’s care process. “We are frequently surprised how poorly patients comprehend their conditions. Once they understand their disease, it’s amazing how well they do,” noted Kathie, who works with a medical assistant to facilitate outreach and patient education efforts. Having point of care educational materials in both Spanish and English within e-MDs has helped support this effort.

A core principle of the medical home is coordination of care, particularly referrals to specialists. Using e-MDs document management tool and referral module for referral tracking, the practice is able to identify all referrals for which the practice has not received a referral report. This gives the staff a hit list to initiate calls to the specialists—either to receive the completed report or to confirm that the patient did not complete the referral. “We are not in the business of writing referrals,” noted Kathie, “We want to make sure that patients are following through.”

A Better Approach to Patient Care

With a combination of strong staff support, judicious use of their e-MDs EHR, and hard work, Dr. St. Louis has successfully transitioned to the Medical Home. Their achievement was recently recognized by the NCQA’s (National Committee for Quality Assurance) Patient-Centered Medical Home (PPC-PCMA™) program, which awarded the practice its rigorous Level 3 Certification. But perhaps the biggest payoff is the professional and personal satisfaction of helping patients. “It makes your patient care better,” summarized Dr. St. Louis. “The patients realize that you really care for them.”