“I hope that over time more vendors will develop specialty-specific templates so physicians’ training time can be freed up a little.”
Among the benefits of EHRs is their ability to aid participation in the Physi- cian Quality Reporting System (PQRS), a program that uses incentive payments and payment adjustments to promote quality information reporting by physi- cians. For more information on the pro- gram, see the TMA website at www.tex
med.org/pqrs. Dr. Fleeger says an out- side vendor accesses PQRS data from his group’s EHR and submits it. “Quality reporting initiatives are going to be some of the main drivers of pay- ment in the future, so it’s beneficial for physicians to adopt and implement an EHR to make the process easier,” he said. He adds that the group’s staff reaped
the potential exodus from one vendor to another is due in large part to EHRs’ in- ability to meet a practice’s needs, a prac- tice’s failure to properly assess its needs before selecting an EHR vendor, and a lack of EHR network interoperability. For more information about the survey, visit
www.blackbookrankings.com. Black Book’s findings reveal that many EHR firms are overwhelmed by a high volume of implementations and product demand, preventing them from addressing development problems. The survey also shows some popular one- size-fits-all EHR products do not meet specialists’ needs and may not continue to satisfy the need for customizable or tailor-made tools. David Fleeger, MD, an Austin colorec-
tal surgeon and a member of the TMA Board of Trustees, echoes that frustra- tion. He’s one of eight surgeons in a subspecialty group that implemented an EHR in 2010. “My group spent six months to a year customizing the templates to apply to our subspecialty practice and conform to our workflow. The vendor expected us to do the design work, and it was a steep learning curve. I hope that over time more vendors will develop special- ty-specific templates so physicians’ train- ing time can be freed up a little,” he said.
32 TEXAS MEDICINE July 2013
Despite encountering a few obsta- cles in the implementation process, Dr. Fleeger says the move away from paper records was worth it.
“The transition to an EHR has been beneficial overall. Although it’s a pain- ful process to get the system up and run- ning, we wouldn’t go back.”
EHRs in practice An EHR helps the 17 doctors at Premier Family Physicians in Austin organize data and communicate more effectively with patients, says Kevin Spencer, MD. The practice’s online patient portal al- lows patients to conveniently make ap- pointments, pay bills, ask clinical ques- tions, request prescription refills and medical records, and update their condi- tions and medications.
“The EHR has templates that provide us with clinical reminders. For example, it will notify us if a patient needs an im- munization or test. Our system also tells us if, for example, a chronically ill pa- tient hasn’t been seen recently. We can then follow up to make an appointment,” said Dr. Spencer, a member of TMA’s Ad Hoc Committee on Health Information Technology.
The EHR notifies physicians in real time of drug interactions and medication recalls, as well, he says.
the greatest benefits from their EHR. “My front office employees spent 20 to 30 percent of their time maintaining, finding, and filing charts; sending faxes; and obtaining labs and x-rays. The EHR has significantly decreased the amount of time they spend doing those kinds of administrative tasks now.” While the EHR improves front of- fice staff productivity, Dr. Fleeger says the technology increases the amount of time physicians spend on medical record documentation. “We used to spend $800 to $1,000 per physician per month on dictation servic- es. We eliminated that cost, but now we spend more time every day completing our charts,” he said.
Do your homework Unfortunately, not every tale of EHR adoption ends happily. An obstetrician- gynecologist group in Dallas sent a let- ter outlining multiple frustrations and concerns to its EHR vendor in April. The physicians requested anonymity. They say the vendor billed for servic- es it either never provided or improperly implemented, and is in breach of con- tract for “improper service and support, substandard training, and outright lies about the product.” The physicians say they lost revenue “due to inability to file claims, monies spent paying staff to fix problems … and lost training hours used to repair [vendor] mistakes.” The letter outlines the group’s cus- tomer service complaints, requests elimi- nation of current and past charges, and
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