Why I Love My EHR: A Physician’s Tale

As the landscape of medicine continues to change with increasing incentives from the federal government to move toward using an EHR in a meaningful way, there is no better time than the present to adopt an EHR for your practice. I started my private practice in 2003 and incorporated the use of a fully functional EHR from day one.

With my EHR, I am able to have a complete snapshot of my practice and be able to see where each and every patient is located at any time. I am able to see what the day's schedule holds in store for me and able to plan more efficiently. Further, with more efficient scheduling and patient management, I am able to do today's work today and refrain from putting off any work for another day that could better be handled today. My office staff also appreciates that I am able to use technology to address our patient requests rapidly.

Some patients require more time than others. As many physicians will tell you, time management can make or break your day. When my reception staff takes receives a call from a patient for same day service, my EHR allows them to see an alert that I have configured that reminds them that Ms. Jones needs to be scheduled either right before lunch or at the end of the day. Such careful planning allows me to devote the additional time for patients that require additional time and prevents me from being delayed in the care of my other patients.

I am also able to provide routine health maintenance for my patients by configuring my EHR rules manager. When a diabetic patient comes in, I am reminded that they have not had their influenza vaccine. I can also see that my next patient, who takes a statin, has not had LFT measurements in the last six months. Anytime a patient over 50 comes in, I can quickly review the time since their last colonoscopy. Such examples are just the beginning of what can be accomplished with the rules manager. Of course, such care can be provided without the use of an EHR, but the use of an EHR allows for that same provision of care to be handled more efficiently.

How does your office handle refill requests? My EHR has a refill module that the nurses can place refill requests into much like an e-mail inbox. Those refill requests can be handled by me very efficiently without disrupting my workflow. While my nurse is getting my next patient ready for a routine gynecological exam, I can handle two to three refill requests while I am waiting outside the exam room. The same refill request module also allows me to see that a patient might be in need of a follow-up visit. As I refill a medication, I can pass along a quick electronic message to my staff to ask that patient to schedule a follow up.

Every practice will have the routine phone call messages, questions, etc. from patients on a daily basis. My EHR has a built in intra-office messaging system that allows my nursing staff to send a patient message to me with the patient's chart attached to the message. Such ready access to the chart allows me to be able to efficiently process the message and then pass the answer back to the nurse.

Our EHR also has a built in online patient portal that allows our patients to be more proactive. Patients can send a message to me directly and the system allows me to send a reply back to them very easily and efficiently. Such messaging does not require a phone call, does not require additional nurse time for the communication and also provides for immense patient satisfaction. At present, about one third of my patients have online portal access and fortunately that percentage is growing each day. Patients can request certain appointment times, request medication refills, view their lab and x-ray results, and they can do so on their schedule at their convenience.

There are many other functions of my EHR that have been put into place over the last seven years. Electronic prescribing has eliminated excess waste in printing prescriptions. Electronic billing and online remittance has greatly improved the efficiency of my office manager and has allowed my practice to receive reimbursement for services that could not be equaled by the use of paper. ICD-9 and CPT coding is no longer a headache. E&M coding is completed more accurately. We have no file rooms or the potential for losing a chart. My file room consists of two servers, redundant data backup and an offsite data repository.

My practice's use of the EHR has been a work in progress over the past several years. While I do not pretend to know it all in terms of having it all figured out, I can say that embracing the use of technology has enabled me to be a more efficient physician for my patients and increase our patient satisfaction as each year passes. Further, the use of a robust EHR will help the physician to focus on what matters most at the end of the day - taking care of our patients.