Dr. Peter Mavrelis: ‘The busy work has been eliminated’

Dr. Mavrelis ’ favorite aspects of WebChart Dictation at the point of service enhances accuracy and builds patient confidence. “I use it to dictate patient encounter notes with the patient right there in the room. They can hear what I’m dictating on my laptop, and if they have questions or corrections, I can edit right then. They know what’s in their file. There are no secrets.” Faxing from the desktop affords convenience.  “We frequently fax to other medical offices that want records or to referral docs to whom we send our patients.”

“We had been looking at the medical-record system made by the manufacturer of our billing software, but it was expensive and not very flexible. Then one of the doctors in our practice, Dr. John Mirro, heard about WebChart from his brother, Fort Wayne cardiologist Mike Mirro. So we went to Fort Wayne and toured medical offices that used WebChart, as well as some that used the system we’d been investigating.

“On that visit alone, we could see that WebChart offered us advantages. No matter what billing system we use, we can use WebChart. The product is very intuitive, and we liked its flexibility. We have nine doctors, and each practices his own way. It would have been hard for me to go to them and say, ‘Here is the system we’ve chosen; you have to do things this way from now on.’

Impact of WebChart on the practice
“The way we capture and review records is better now with WebChart. Before, we were crushed under the weight of our paperwork. We were falling all over ourselves trying to locate paper charts. We were so far behind on our dictation that we decided to outsource half of it to India. We’d call it in to a phone bank, a typist in India would send it back to us as a transcribed note, and then we’d download it, print it, and paste it into a paper chart.

“Now practically all of our dictation is done here by two transcriptionists. The efficiencies of WebChart have brought the work back home. WebChart has increased our productivity. Instead of being chart runners and transcription pasters, our nurses are now able to focus on patient care. The ‘busy work’ of medicine has been eliminated.

“Confidentiality of files is improved, too, because they’re password-protected. Our practice fully implemented WebChart seven months ago, and we’ve already removed six shelves of paper chart files. By the end of this year, we should have most of our old records converted to the new format.

How staff members have adapted to WebChart
“Some of the doctors resisted it slightly, but they had the feeling that this was the right thing to do. Staff was very worried, worried about change, that their jobs might be eliminated. On the other hand, the work was overwhelming them. They had to spend too much time searching for charts. Now they’ve really embraced WebChart. It has doubled their efficiency. All the physicians use it; we each have our own format.

Overall impression of WebChart as a tool
“I love it. I recommend WebChart to other practices. It’s unbelievable how this product will continue to revolutionize the way we practice medicine over the next 10 years.

“It’s simplified the way I do my job. As physicians, we have to integrate information, and WebChart allows me to do that quickly and accurately. It has allowed us to practice a better quality of medicine because the information can flow seamlessly wherever it’s needed. We use our satellite offices more effectively now.

“WebChart has been a good value, and it’s worked even better than I had hoped. And MIE has been very receptive and sensitive to our needs, even though they’re far away.”

Dr. Jeff Bessette: ‘WebChart makes it easier to read studies’

Aspects of WebChart RIS/PACS Dr. Bessette finds helpful Image manipulation "One study used to take a lot of sheets of film. And contrast was a big issue, given the difference in density between bone and soft tissue. Now if I need to see a different view, I can use window leveling to adjust the image, to see it better. User-friendliness for community hospitals "We're at Paulding County Hospital two days a week, a half day each time. The rest of the time, they send us images to review via MIE's server. That works well, and they like it a lot."

“In 1997, we started Open View MRI, and we didn’t want to have someone constantly running jackets back and forth to that remote location, so MIE engineered a data line to transmit images to and from the center. MIE also created a means to convert the images and put them in a cache to await transmission to another site for reading. That was pretty novel, because no one else could do it at the time.

“Then we opened an MRI scanner at an orthopaedics center, and we needed to receive images from otolaryngologists and other specialists, so MIE enabled us to do that. We just kept expanding the number of MIE services in use, adding functions as we’ve needed them. MIE keeps writing code to let us do what we need—it’s been a progression.

“Two to three years ago, we switched to WebChart for scheduling; we had been using a hospital system. Now we use MIE for our wide-area network, storing and retrieving images, dictation, transcription, scheduling, tasking and other workflow. We store images on MIE’s server, and ship them to and from medical oncology centers, “oto” offices, our two Open View MRI locations, our MRI center, and orthopaedic and allergy clinics.

Impact of WebChart RIS/PACS on the practice
“When we used film, other staff had to help with the work. A staffer would hang the films up on a roller to load them, and the radiologist would hit the pedal, read, hit the pedal, read. But everything had to be just right for that to run smoothly. Now, while you do have to know exactly what you’re looking for to pull up the studies on the computer, access is easier with PACS.You don’t have to waste time going through a big, thick jacket of patient information, which can be like searching through a shuffled deck of cards.

“Some of my partners were uncomfortable with PACS at first; they kept wanting to get out the films. But now they use it all the time.

“WebChart RIS/PACS makes it easier to read studies, and eliminates time previously spent carrying jackets and film back and forth. Acquisition of old studies for comparison is much simpler; once they’ve been stored in the system, we can pull them up anytime we need them. Nobody has to go and dig around in the basement for old films. It’s made us more efficient, and reads are more accurate now, too.

“Plus, if I have questions or need a second opinion (from another specialist in the practice), we can both pull up the image on the computer and discuss it over the phone.

Overall impression
“WebChart RIS/PACS has been very good for us. And, it’s a great value. If we have a problem, MIE responds very quickly.

“I like working with MIE; they’ve been very helpful over the years. They’re a wonderful group to work with, but above all, they understand our practice.”

Donette Braun: ‘We’ve made huge progress’

Donette Braun’s favorite aspects of WebChart Faxing from the desktop improves efficiency. “It provides quicker turnaround and helps us on the transcription side, too.” Hospital documentation flows right into WebChart, meshing with in-house dictation to give the complete picture on a patient. Once the link is established, any future hospital documents flow right into WebChart. “The hospital interface is just incredible. Our physicians doing rounds can access patient histories and notes from the attending physicians as well as nurse and tech schedules.”

“In 1999, we were getting ready for Y2K when the server storing all of our transcription work crashed. (We called it our ‘D-Day.’) We had a different provider for our document-management system, but Doug Horner and his associates worked tirelessly to recapture all the lost data. In the process, they tweaked our system for us, and the relationship between Fort Wayne Cardiology and MIE grew from there. If we had problems, MIE programmers would work ‘Dracula hours’ so the system would be up again the next morning. We thought, ‘Wow! What a company to be so willing to accommodate us and customize functions to our needs.’

Impact of WebChart on the practice
“When our previous document-management system crashed, MIE pulled our data into WebChart, which made the data usable again. That was our first exposure to WebChart. Five years ago, we started using its transcription module. Soon we’ll implement the dictation module, which has received great reviews from two of our physicians who have tested it for us.

“I supervise seven transcriptionists who like WebChart’s keyboard shortcuts and its ability to automatically populate information such as physician and patient names and medication lists, not to mention fill in a page-two header. Features like that save a lot of time and allow dictation files to be turned around faster.

“We’ve made huge progress scanning documents into the system. Each day, we free up a bit more space in our file room.

How staff members have adapted to WebChart
“With 21 physicians who visit 11 clinics, our practice is very complex. We have many paper-and-pen systems in place, and we don’t want to interfere with the documentation accuracy we have now. So we’ve introduced changes gradually. Anything new has to work better than what we’ve used successfully for years. MIE’s Bridget Hamm and our senior staff do a lot of role-playing to work through integrating each new function. It’s about gaining efficiency without compromising patient care.

“It’s taken time to get some of our staff into the point-and-click mindset, but overall, the practice is really embracing WebChart and the chance to access so much more information than we’ve had before.

Overall impression
“WebChart is a great tool. It’s very straightforward and easy to use. But the process is just as important as the product, and MIE has helped us determine how to implement its features to make it work best for us.

User group benefits
“The User Advisory Group is truly worthwhile. Our director of clinical operations and I attend. At one meeting, I learned that a group was using insurance-card scanners to scan photo IDs, too. Now we’re doing it, so when a patient calls, the physician or nurse can picture the person on the other end of the line. It’s exciting to get helpful ideas like that and implement new procedures so quickly and easily.”

Dr. Tom Dumas: ‘WebChart has made us more efficient’

Dr. Dumas’ favorite aspects of WebChart Real-time response and a tasking function allow smooth communication among medical staff. “The nurse can take a question from a patient, use WebChart’s task function to alert me that I should consult the chart and advise her, and we take care of the matter without making the patient wait a long time for an answer.” The electronic-signature feature saves time in authorizing billing documents. “With a couple of clicks, I’ve ‘signed’ it. Medicare and Medicaid recognize an electronic signature as legal and valid. I can examine and ‘sign’ 50 documents in a matter of minutes, whereas before it would take much longer.”

“Our group looked for three or four years for a digital charting system. We went to national conferences and spoke with a lot of vendors. Many systems would have accomplished the same basic functions, but we would have had to change the way we practice to accommodate the system. These systems would have forced us to run our practice the way the programmer thought we should.

“We talked to Doug Horner about that. Doug had worked on our computer system for us, because the people who sold us the package didn’t support it anymore. Whenever there was a problem, Doug would find a way to fix it. Doug said a digital charting system should support the way we practice medicine, not change it. And he was right—since we started working with WebChart a year ago, we’ve found that it just molded into what we wanted.”

Impact of WebChart on the practice
“Our office used to be very chart-dependent, so it was a real culture change for us to go from paper to something electronic. We spent a lot of time trying to track down charts. With WebChart, the patient’s chart is right in front of us when we need it. In fact, the chart can be in five places at the same time, anywhere there’s a computer terminal. If I’m on call, or at a hospital, and I need to answer a question, I can access the information right away. Having the chart at my fingertips allows me to ‘see’ more patients, since I can handle more things by phone, and it saves patients office visits.

“We also store CT scans on the system, and that saves money and time. We’re even looking at getting a couple of computer terminals in the operating room, so that we can view the CTs on screen while we operate.”

How staff members have adapted to WebChart
“We have 10 satellite offices, and nearly all of them are hooked to WebChart. You don’t have to be a computer expert to use the system, just willing to experiment with it. My secretary was the first person in the office other than me to learn the system, and it was great to see her teaching 19-year-olds how to use it. She saves loads of time with it, simply because she doesn’t have to locate charts.”

Overall impression of WebChart as a tool
“I don’t know how we’d exist without it. WebChart has made us more efficient. I really think we’ll notice a substantial decrease in our overhead because fewer work-hours are required to complete a task now that the chart doesn’t have to be located. And it’s great to deal with someone local. With out-of-town vendors, you never know who you’re going to get. And you wonder if they’ll really stick with you the way MIE does.”

Staci Wall: ‘We were determined to push the limits’

Staci Wall’s favorite aspects of WebChart WebChart templates can be created for almost any required task. “One problem with paper charts was that if a patient mentioned that she’d had, say, gall-bladder surgery, the information would go into a note for that visit but not into her general history. Our goal is for the medical history to be current every time the patient comes in. We now have an electronic history form in WebChart that we update and print out for the patient to review during each visit. (The form was developed in conjunction with NoMoreClipboard, MIE’s online patient-history repository.)”

“Our merger a few years ago prompted us to look into electronic systems. We had separate record-keeping systems for our three offices, and we needed to find a way for them to work together.

“When we shopped around, we found that many companies would only offer practice-management systems with their electronic-medical-records (EMR) systems, and the EMR systems either didn’t do what we wanted or were prohibitively expensive. Then we sat down with MIE for a WebChart demonstration and they asked us, ‘What do you want it to do?’ We liked the fact that MIE had a user-friendly document-management system, and we saw the potential for building the system around the way we want to practice. We were determined to use it to its fullest extent, to push its limits.

Impact of WebChart on the practice
“At the time of the merger, most of our records were paper, with a small portion in an electronic system that wasn’t easy to navigate. The conversion was a lot of work, but MIE was helpful in creating WebChart modifications that helped us troubleshoot problems we had in other areas.

“We no longer pull charts. Our 20 physicians are almost paperless. We’ve standardized an exam template that meets all Medicare guidelines for coding, and our physicians use it for dictation. Transcription turnaround is much shorter. Our system is commonsense and easy to learn. WebChart has united our practice. There are many ways to do things correctly in medicine; WebChart gives us the flexibility to explore the different ways we each like to practice.

How staff members have adapted to WebChart
“Staff participation in the WebChart transition was absolutely remarkable—and, of course, instrumental in making the shift with very little disruption in patient service.

“The transition took approximately six months. We began by scanning charts into the system as patients scheduled appointments. By the fall of 2002, we were able to finish scanning all patient charts. Now our old filing system is virtually empty.

“With change always comes a certain amount of frustration, but MIE has always helped make the process simple. The WebChart training we received was great. MIE usually installs software upgrades afterhours. The next day, the MIE technician is at our office first thing to provide any support we need.”

Working in partnership with MIE
“I joined MIE’s User Advisory Group in November. At the meetings, it’s great to get the heads-up about new features, but the best thing is the networking—sitting around the table with people from different practices, people with whom I might not normally have contact. There’s always a computer on, so we can look at the way one group or another has chosen to do things, and we learn from each other. And MIE has such a good rapport with its clients that Doug and Peter invite other medical groups to visit us to see how we handle issues within our practices. I enjoy the visits and being able to show off our system.

“We talk about the industry at User Advisory Group meetings, too. MIE does a good job of letting us know about its activities and ways the company is moving forward. That gives me a sense of security that we’ve chosen a company that’s going to be around for a long time. I think it’s very appropriate that MIE is taking a leading role in projects like NoMoreClipboard and the community database that will benefit so many and advance the way medicine is practiced.

“I also think that MIE will become a model for other vendors and their systems. MIE started with a strong core system, and they’re building out from that in concentric circles. They’ve tried not to grow too quickly because they want to maintain the high level of customer service they have now. Really, not many companies will give you their top managers’ cell phone numbers. And I know that whenever I have a question for Doug or Peter or Eric, they’ll listen to me. And they’ll have ideas for solutions.”

Karen Willcutts: ‘Our old filing system is virtually empty’

Karen Willcutts’ favorite aspects of WebChart WebChart improvements have continued to be a collaboration between MIE and its customers. “With other software packages, you buy as is—there’s no built-in flexibility. But WebChart is continually tailored to fit our needs. That’s what makes WebChart unique.” WebChart already includes the security necessary for compliance with the Health Insurance Portability and Accountability Act security standards.  “In reviewing implementation requirements for the standard, it’s clear that, with WebChart, Fort Wayne Dermatology now has most of what we need for compliance.”

“As our practice expanded, we were storing charts in a file system that rapidly was running short on space. It was apparent that, to eliminate storage issues, electronic medical-record storage was becoming a necessity. But there was more to it than that.

“The old medical records made it impossible for more than one staff member or physician at a time to access a patient’s chart—and keeping track of the paper trail in the course of day-to-day operations was a nightmare.

“We had been a customer of MediSys, a Fort Wayne software company that provided the program Medical Manager, since 1989. We relied on MediSys—where Eric Jones and Doug Horner were employed—for software to manage our accounts receivable, insurance billing, and collections.

“In 1995, Eric and Doug established MIE. So, we followed Eric and Doug for hardware support. I’d been interested in an electronic medical-records system for some time. MIE approached us to test its software, and we found that we could still use Medical Manager because it interfaces with WebChart.”

Impact of WebChart on the practice
“In October 2000, with Dr. Bradley Boyd heading up the project, our practice began scanning patients’ medical records. Almost immediately, the impact on practice efficiency was astounding. Patient medical records were available within seconds after dictation—and not only at one practice location, but at any location with a connection to the Med-Web.

“The savings we’ve enjoyed already have come in the form of less staff time spent tracking down charts for appointments, phone calls, billing, and lab results.”

How staff members have adapted to WebChart
“Staff participation in the WebChart transition was absolutely remarkable—and, of course, instrumental in making the shift with very little disruption in patient service.

“The transition took approximately six months. We began by scanning charts into the system as patients scheduled appointments. By the fall of 2002, we were able to finish scanning all patient charts. Now our old filing system is virtually empty.

“With change always comes a certain amount of frustration, but MIE has always helped make the process simple. The WebChart training we received was great. MIE usually installs software upgrades afterhours. The next day, the MIE technician is at our office first thing to provide any support we need.”

Overall impression of WebChart as a tool
“WebChart is very stable, with virtually no downtime. If a disruption does occur, we’re MIE’s first priority. And, of course, WebChart continues to make us more efficient. We’ve eliminated the need to pull charts for ‘phone triage,’ and WebChart’s Forms Library allows us to produce as many different forms as we need, each with patient information and a bar code. All of this helps us provide even better care for our patients.”