NEW ENGLAND FAMILY MEDICINE

Dr. Harveen Singh, a solo family physician in Framingham, Mass., was one of the first doctors in her region to successfully attest that she was using her electronic health record (EHR) according to the federal government’s Meaningful Use guidelines. Not surprisingly, she uses eMDs, which in 2010 was named “best in KLAS” for small practices by the KLAS health IT research firm.

Dr. Singh, who did her residency at Mercy Hospital in Pittsburgh, worked for Western Florida Hospital in Pensacola for two years. In 2007, she decided to form her own practice so she could spend more time with patients and deliver care that met her own standards, explains Roger Singh, her husband and practice administrator.

The Singhs decided they wanted to start New England Family Medicine with an EHR. Dr. Singh had been using one in her hospital group, and Roger insisted that they get one for their new practice as well. An engineer by training, Roger had no prior experience in healthcare.

“But I said, ‘If we start a practice, we need to begin with an electronic record,” he recalls. “’I don’t want to do anything paper-based, because that’s going backward.’”

The couple began looking for an EHR and compared many different systems over a 6-month period. They were about to sign a contract with an EHR vendor when Roger received a phone call from his wife, who was attending the annual meeting of the American Association of Family Physicians. A Texas doctor had given eMDs a strong endorsement, she said, and she wanted to check it out. It was a good fit. In January 2008, when Dr. Singh began seeing patients in Framingham, she was using eMDs.

TRAINING AND IMPLEMENTATION

The Singhs went to eMDs’ headquarters in Austin, TX, for training. Dr. Singh caught onto the documentation functions right away. Roger focused on the practice management side. Within six months both of them were fully up to speed on the essentials of using eMDs, he says.

Dr. Singh used eMDs’ electronic prescribing from the outset, and the practice soon acquired a highspeed scanner to take advantage of DocMan, eMDs’ document management module. In addition, Dr. Singh uses eMDs to generate referrals, and using a local health information exchange, they are computer-faxed to specialists. The practice recently began utilizing the EHR’s patient portal as well, which allows Dr. Singh to share lab results, appointments and health maintenance reminders directly with patients.

With the federal EHR incentives on the horizon, the Singhs knew they’d need a lab interface to show Meaningful Use. Their lab vendor, Quest Diagnostics, agreed to build an interface for the practice at Dr. Singh’s request. The interface has worked very well, delivering lab results directly into the patient’s electronic record as structured data.

PREP FOR MEANINGFUL USE WITH HELP FROM MASSACHUSETTS EHEALTH INSTITUTE

Early on, the Singhs decided to enroll New England Family Medicine in the national regional extension center (REC) program that helps primary-care physicians implement EHRs and show Meaningful Use. In fact, the practice was the first in the area to sign up with the state’s REC, the Massachusetts eHealth Institute.

The Singhs made this choice because they didn’t want to be “under the gun” as the Meaningful Use deadline neared, Roger says. “It’s easier when you’re learning and implementing things at your own pace.”

The REC kept the practice apprised of the changes in the Meaningful Use rules as they were being finalized. It also referred the Singhs to HealthLens, based in Northampton, Mass. A nonprofit membership organization, HealthLens is one of the implementation optimization organizations that have contracted with the REC to help practices demonstrate Meaningful Use. In addition, HealthLens hosts, maintains, and supports eMDs as one of the services that physicians receive in return for membership fees.

The Singhs were already familiar with the features of eMDs that would help them show Meaningful Use. They learned more from eMDs’ webinars and its online support center. HealthLens provided invaluable assistance by walking the practice through the details of what they had to do to successfully qualify. “HealthLens showed us how to run the reports we needed,” says Roger. “We looked at the data in the reports and that helped us go through the attestation process on the CMS website.”

On May 19, 2011, Dr. Singh attested to meeting the criteria for stage 1 of Meaningful Use. About a month later, the practice received a government check for $18,000.

NEW FOCUS ON PREVENTIVE CARE

Besides the financial benefit, the process has been a plus for patients. To prepare the practice for Meaningful Use, HealthLens taught the Singhs how to use eMDs’ Clinical Reminders System. Along with eMDs’ strong clinical reporting, which allows the practice to track the clinical activity of their patients, New England Family Medicine uses the clinical reminders feature to trigger outreach to patients who are overdue for preventive services, including mammography, colonoscopy and other screening tests.

“Now we’re proactively calling the patients and trying to get them in,” Roger notes. “and we did that because of Meaningful Use.”

Providing high-quality care is very important to Dr. Singh. eMDs’ automation of processes like patient tracking and monitoring helps her do that, even as her patient panel has grown very large.

KEEPING OVERHEAD DOWN

When the Singhs started New England Family Medicine from scratch, they had just two employees: a receptionist and a medical assistant. Today, the practice has 2,400 active patients and is seeing 23 to 25 patients a day, but it still has only two staffers.

Roger attributes this low staffing level to the efficiency that eMDs has created in the practice. “As our workload grew, so did our efficiency. eMDs has made a tremendous contribution to our success.”

E-prescribing has reduced the work involved in prescriptions, and electronic referrals have simplified that process, as well, Roger explains. Scanning documents takes much less time than pulling and filing charts. And it’s easy for the receptionist to answer patients’ questions when they call, because she can quickly open their chart in eMDs.

The practice management side of eMDs has also helped the practice financially, Roger points out. He does the billing himself with eMDs practice management software and the rejection rate from the claims clearinghouse he uses is under 2 percent.

“You can’t have this kind of efficiency with paper billing or with a billing company,” he notes. “The biggest asset is that we have the information available, and you only have to enter it once, although it gets utilized in many different ways.”

RETURN ON INVESTMENT

As a result of the efficiency gains and optimized billing made possible by eMDs making the practice more efficient and the excellence of its billing system, the practice has recouped its EHR outlays many times over. “It’s one of the best investments we made,” Roger says.

The Singhs are also very satisfied with eMDs’ support. Roger particularly praises the company’s assistance with Meaningful Use. “eMDs did a great job, not only with their 7.0 version, but also with putting the tools on the support center. They also did webinars that were useful. And they knew we were going for Meaningful Use, and they gave us wonderful support whenever we called.

“We have a very good feeling about eMDs, and we’re extremely happy with our investment in the EHR,” he concludes.

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