Health Information Technology Pinnacle Family Medicine

1. Health Information TechnologyPinnacle Family Medicine • Michelle Eads, M.D. • Practice Setting • Community solo practice • Family Medicine • One physician • Colorado Springs, Colorado

2. 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

3. 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

4. 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

5. 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

6. 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

7. 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)

8. 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

9. 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

10. 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

11. 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

12. Contact Information www.PinnacleFamilyMedicine.com drmichelleeads@alteer.com

13. Suggested Resources www.centerforhit.org Center for Health IT at the AAFP How 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.html Why I Love My EMR www.aafp.org/fpm/20021000/35whyi.html Computers www.aafp.org/fpm/20020400/57howm.html The EMR: Not Just a Computerized Chart www.aafp.org/fpm/20010100/08thee.html Avoiding Common Pitfalls in Selecting an EMR www.aafp.org/fpm/classicstello.html Solo 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

14. 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

15. Outcomes example using HIT Enhanced PCCC