The Practice Administrator: Moving to an EHR System

In 2007, my wife opened a private medical practice, Brazosport Urology, in our hometown of Lake Jackson, Texas. While my background has been in IT, her clinic quickly became our family business and I took on the role as practice manager. It was quite the ideal set up - she could spend time thinking about her patients while I spent my time running the business end. After a while it was clear that we needed to move all of business items - from billing to prescriptions - to an electronic system. 

From my previous experience working in enterprise IT environments, I felt I was in a better position than most practice managers. I understood the costs and commitment involved in maintaining an on-premises system, and I knew what to expect during the selection process. After getting referrals and doing my initial research, I determined that moving toward a cloud-based system would be best for our growing practice. The price quotes on a standalone system and time and resources involved in managing a SQL server, backup, desktop clients, and everything in between that goes into managing a server in-house was just not the best choice for us.

Obviously, hospitals and large managed health care centers have the resources to implement some of the larger, more legacy-based systems - but more importantly, they have a need for these types of systems. Think of it this way, it would be like giving a small business owner an IBM mainframe to run their business. They don’t really need it or want it and they can’t maintain it. It’s daunting, and because of this I saw that many of our counterparts were putting off moving to an EHR system. It’s not that they don’t see the benefit, or want to take advantage of the government incentives, it’s more the fear of undertaking such a big project that they know nothing about.

Even with my technological background, we still needed a less complex, shorter learning curve, yet strong application for our mid-tier practice. Looking at our list of desires and needs, we quickly realized that one issue that we wanted resolved with our EHR system was the inefficiencies of paper/phone/fax-based prescribing and prescription filling. Our staff would routinely spend extended periods of time on hold with or contacting pharmacies regarding particular scripts and physical proximity to patients.

Many patients - feeling the economic pinch - would request less expensive alternatives to their regularly prescribed meds, something that also required tedious formulary research and verification. And filling or refilling scripts on nights and weekends was always a time-draining experience. Additionally, all of these inefficiencies precluded our practices’ ability to focus on expanding the patient panel and ensuring the highest quality customer service possible. With our location, word-of-mouth is key, so we try to make sure everyone leaves here with something good to say about us.

The process of finding the right EHR system isn’t always easy no matter what your background, and we even switched systems after just six months with the one I initially selected. But in the end, it was worth it. An unexpected benefit of finding the right EHR was its impact on our quality of life - both at the office and away. Both our doctors and staff have seen a boost in productivity provided by the system; not only are they working more efficiently, but they are freed from menial tasks and able to focus on issues that directly impact the growth and success of our practice. We’ve found that we can do some things that used to take up to 30 minutes in less than a minute, and that frees all of us up for more satisfying, strategic revenue-generating and value-creating activities, such as customer service or prospecting - which goes directly to our bottom line.

Derrick Berger is the practice manager for Brazosport Urology in Lake Jackson, Texas. With a 15-year background in IT, Berger has helped his wife, Dr. Alisa Berger build their urology medical practice from the ground up with no prior medical office experience.