Steve Smith, M.B.A., C.M.P.E. Is the General Manager and C.E.O. of Allied Physicians, Inc. a multi-specialty medical group. The Fort Wayne Neurological Center is a Neurosciences Center of Excellence within the Corporation. It houses the specialties of Neurology, Neurosurgery, Physical Medicine, Rehabilitation and NeuroPsychology. Mr. Smith received his M.B.A. from Indiana University and is a Certified Medical Group Executive as designated by the national Medical Group Management Association. Mr. Smith has been associated with API for nearly twenty years.
Affiliations: Various ancillary component departments of the Fort Wayne Neurological Center are accredited by the American Association of Ambulatory Health Care (AAAHC), the American Academy of Sleep Medicine (AASM) and the Commission on MRI Quality and Safety (CMQS).
Fort Wayne Neurological Center (FWNC) was established in 1989 and is the region's premiere center for neurological medicine. The Center has established ten specialized patient-focused Institutes of Care to ensure that patients receive the best medical care for their specific condition. The Center has 20 physicians who are supported by a staff of nurses, medical assistants and medical secretaries in addition to teams of clinical professionals in the areas of Diagnostic Testing, Nuclear Imaging, Ambulatory Surgery, Sleep Medicine and Research.
FWNC has two main offices in Fort Wayne, Indiana and routinely treats patients in a 90 mile radius of Fort Wayne including northeast Indiana, northwest Ohio and southcentral Michigan. The Center also maintains regional clinics in Indiana and Ohio, as well as at all area medical and specialty hospitals.
WebChart EHR; WebChart Document Management
Our practice implemented WebChart in a phased approach, starting with document management as a way to store records and replace paper charts. At first, none of our doctors were using WebChart in a clinical setting. Our medical records staff used the system, and our physicians could print the bar-coded documents they needed on demand. Following clinical encounters, completed forms were scanned and auto-indexed into WebChart. Over time, we added functionality so that our physicians could use PCs to view patient information in WebChart, rather than on paper. Now, all of our prescriptions and orders go out electronically and physicians can view records and images on their home PCs.
Q: What “symptoms” was your practice experiencing prior to adopting an EHR? How did these symptoms lead your practice to explore the adoption of an EHR?
A: We have 1.2 million potential patients in a 90 mile radius. Our physicians do much of their work in hospitals. In the paper world, we would get data from hospitals all over – mail, faxes, paper charts, etc. Our medical records staff had to pull charts over and over again when our patients were in the hospital, alphabetize, add paper and re-file. Now, we receive pathology reports, radiology studies and other in-patient data electronically. We can view the information on screen and easily index it to the right spot in the electronic chart, saving us time and money.
Q: What were some of the challenges your practice faced in deciding to adopt an EHR?
A: Some of our physicians and office staff did not want to use the computer. Purchase of a system was cost prohibitive. WebChart’s ASP approach allowed for a graduated ease of entry and lower cost.
Q: How did you overcome those challenges and decide to move forward?
A: We avoided trying to bring all our physicians on at once. We started with the early, enthusiastic adopters - we call them the “Eagles”. Then we moved to the physicians who were not opposed, and would go along - those were the “Pigeons”. Finally we went to the “Chickens” and eventually gave them no choice but to use WebChart! People got more comfortable working online, with the occasional piece of paper to document an encounter. Then we gradually added computers in physician homes so they could view records and images 24 X 7. This made being on-call easier, and our doctors realized they could avoid a trip to the hospital or office in the middle of the night. They were able to see more information, make better informed decisions, and give better direction to hospital staff in the ICU or ED.
Q: Why did you select MIE over other potential suppliers?
A: MIE’s Minimally Invasive approach worked well for us. With MIE, we were able to implement one doctor at a time versus a mass production, throw the switch approach. Our policy is not to force anyone to use the EHR. We will support paper based patient encounters to a certain degree, and we still have a few physicians who are somewhat paper-based. For doctors who are averse to an EHR, we can still print out their five page mini-chart for that day’s encounters, they can dictate into WebChart, and they never have to use a computer screen.
MIE also tailored our EHR for our practice. We have upwards of 40 tabs, based on the way we practice medicine. There are two very different approaches to EHR software. Most software vendors put the software in, and any customization is done on a “we’ll see, maybe if enough other customers want it we might get to it someday” basis. With MIE, it is not uncommon to talk with one of their software engineers about a request and find that two days later it’s done. MIE also brings suggestions from other practices. They show us how other people are using the system and we can choose to add that functionality. WebChart is very flexible and adaptable, and can be tailored on the run.
It is the most user friendly software system we have ever encountered.
Q: What immediate benefits did your practice realize as a result of implementing WebChart from MIE?
A: As a medical group manager, you hear all the problems. That’s why for me, the silence is the best thing about WebChart. I don’t hear any of our physicians saying it doesn’t work, or this was a mistake. WebChart works, every day. I can rely on it, and I am not putting out 100 fires and answering questions about the system being slow or pages disappearing. I just hear silence – the quiet hum of WebChart working. The specific benefits are as follows:
Q: What specific cost benefits are you seeing as a result of implementing WebChart from MIE?
A: The total cash savings or increased revenue from our EHR system is at least $250,500 per year, broken down as follows:
Q: Did the implementation match your expectations? What surprised you?
A: It absolutely matched my expectations. While I hear tales of woe from other practices using an EMR, I never hear anyone at our place say “WebChart slowed me down.” Our high producers are still high producers. WebChart does not make them more productive, but more efficient and better able to use their time.
The WebChart platform also enabled us to do some other things we did not anticipate. For example, we have started a stroke care initiative that incorporates telemedicine and relies on the electronic chart. We are also able to use the EHR to track and report on quality and e-prescribe, qualifying us for available incentive payments. Finally, the system has helped us with our recruiting efforts. It helps that we can show a fully integrated, 100 percent web-based EHR that can be accessed at home, in the hospital or at the office. WebChart helps us distinguish our practice and it adds a professional halo that helps us recruit new physicians. We just hired a new physician who came from a State University in a major metropolitan city who is telling us our EHR is far better and more sophisticated than what he is used to.
Q: What is your advice for smaller practices that are concerned about the price of an EHR system?
A: The implementation cost for MIE’s WebChart is very reasonable, as are the monthly ASP fees, so you could describe the cost as “minimally invasive” to the practice pocketbook too. We are starting to see competitive prices come down, but WebChart is still more affordable.
I would advise practices who are going to purchase an EMR with stimulus incentives not to wait until 2010 or 2011. The good systems vendors will get backed up, and you will blow your first year of incentive payments. Smart medical groups will get on the path now and adopt an EHR at a comfortable, incremental pace.