No More Wheels
A couple of years ago you may have seen Janice Birney, M.D. rolling a suitcase from her office, to her home, and back to her office in Littleton, Colorado. If you see her today, suddenly it hits you. Gee, something’s missing. She’s not dragging her suitcase. Why did she chuck her baggage on wheels? What was she toting back and forth?
Corey Sexton, who took the IT reins at Dr. Janice Birney’s ENT office two years ago is privy to the answer. “She used to take many paper charts home and she’d have to load up a suitcase and roll it home. WRS has helped her a lot in that regard,” said Sexton.
Dr. Birney has been in practice for over 25 years, specializing in Otolaryngology and Facial Surgery. She treats adults as well as children and performs surgeries at a nearby Surgical Center.
Sexton, whose curricula vitae includes IT stints at a law firm, a server company, USGS and not surprisingly, fixing his friends’ computer glitches, was originally called to the practice to set up AllMeds EMR. “They planned to switch from paper charts to an EMR company and by the time I was called in, Dr. Birney had already decided her EMR was AllMeds. I was in charge of getting the office compatible with that EMR. She didn’t like the company. The interface was difficult to use. The price was too high. She felt, ‘I can’t continue on with this company.’”
What did the search for an ENT EMR entail? “Dr. Birney gave me the criteria. She’s very busy. She let me make all the calls. If I found something, I’d run into her office. I’d set up a meeting and she’d sit in on the presentation. The whole office would deliberate as a group,” said Sexton.
As he discusses the practice’s EMR criteria as well as his IT knowledge, it is apparent that Sexton is being humble when he describes himself as “just the IT guy for the practice”. “One of the biggest things was price. I didn’t get a whole lot of say-so the first time around. I wanted something that was more up-to-date, because our previous EMR was old fashioned. To check patients in, there was a bubble scantron sheet and the patients hated it. They had to use these old fashioned serial ports for the scanners that would only technically work on Windows XP, and Microsoft stopped supporting that (platform) years ago. I didn’t even listen to their requirements and bought mostly Windows 7 pro machines.”
Sexton searched EMRs online and visited online third party review sites to see “what was out there and what people liked. It had to be geared toward ENT since that is what Dr. Birney practiced. General practice or family medicine based EMRs wouldn’t really work. There were a lot of those kinds of EMRs, but we wanted something more geared to her specialty, so that narrowed it down. We looked at three companies. Dr. Birney found one that she liked, but it was just a general practice software system. We didn’t even try it out. I found the WRS web site and also found reviews of WRS. I checked out WRS web site because online people were saying, ‘This is great.’ So I looked at WRS and found a lot of the criteria I was looking for. It was web based, so that cleared up a lot of problems that we originally had with the other EMR. I saw the Digital Pen for checking-in people and new patients and I said, ‘WRS is definitely up-to-date on that.’ The price was way better. And then, I liked the fact that they don’t charge per page for incoming fax and outgoing faxes. It’s all included in the bundle,” stated Sexton.
Dr. Birney’s staff, which includes an M.A., two Audiologists, a surgery scheduler and a front desk office manager, had input in the selection of WRS. In July 2011, after giving a thumbs up to Waiting Room Solutions, the practice began implementing the ENT EMR. “We had to get everything up and running in three weeks. We had all of our data pulled from the old EMR and transferred to the new one. We went live August 20. It was really fast. The whole process was handled really well so we were really happy with that. What we mostly like is having a single point of contact. We are not really familiar with everybody at WRS so knowing one person who is the chain of communication with the rest of the company is fantastic. We really liked that a lot. Our account representative, Melissa, is great. Her responses to our questions are so thorough. We were not used to that, so that’s a real plus.”
Like many ENT physicians, Dr. Birney’s patients have varying conditions and complaints. Sexton explained in his case study that while she is using templates for certain common symptoms or items, she has also created what he dubbed, “mini templates.”
“We preprogram those common conditions in the ENT EMR with certain codes and it automatically populates the note. She sees so many different patients. ‘You may have an ear ache, but you don’t have this.’ Pretty much every patient who comes in is different than the previous one so we built mini templates. They have a, b and c. We click those and they populate with the codes that go with it. The entire visit may not be a template, but certain parts are. Some things are easily generalized, while others are more specific. We tailored the EMR to meet the specificity that we need and we also try to make it quick with templates.”
The Magic Pen
Checking-in new and existing patients can be a time consuming ordeal for a practice’s staff as well as its patients. “One of the biggest problems we had with our old EMR was the actual check-in process. It was so slow. We had to give the patients two bubble sheets, front and back. They would fill it out, hand it back to us and then we’d send it through this scantron reader and we had to assign a bar code to it. It took forever. It took 15 to 20 minutes to check one patient in, especially a new patient if we didn’t have their information in yet. That was on top of all the old paper work for HIPAA that we used to give to people. Patients were unhappy. The check-in process was long. We were getting behind in our schedule. When we saw the WRS Digital Pen, we said, ‘This is one of the best things ever.’ We just give patients the pen. They fill it out. It takes a picture of everything they write. You put it in and you are done. It just streamlined everything. The patients are happier. The check-in process is a lot smoother. We are down to five minutes for a new patient with all the paper work.”
Patient Portal Pluses
If speeding up the check-in process with the Digital Pen wasn’t enough, the integrated WRS patient portal is yet another tool that is making this practice run smoothly. “If the patients give us an e-mail address we send them automatic e-mail reminders about their appointments. They can do all of the paper work through the portal. We’ve uploaded our HIPAA form. They can fill out their insurance, providers, pharmacies and medical background online. The majority of patients that Dr. Birney sees are elderly and they may not understand how the patient portal works, but a few patients have used it. There are some elderly people who are all for it. They love it. They come in and sit down and say, ‘Everything is done.’ That makes it easier on us too because we don’t have any of that work. And then there are some younger people that Dr. Birney sees. It’s hard to find someone who doesn’t have an e-mail address in that age group.”
Rxs Fly out the Door
E-prescribing is yet another WRS capability that is streamlining Dr. Birney’s ENT practice. Sexton explained, “E-prescribing is going very well. It’s easy. Once the pharmacy is loaded in the EMR, we just type in the name of the drug. It was a little tricky at first because of the labels for some of the drugs. It could be a unit, cartridge or a bottle so we had to get used to that, but overall, especially once you get it loaded in there, it is saved in your ‘most used’ list. It’s great. You just click on it and electronically prescribe it,” said Sexton, adding, “I don’t even know if the patients realize we e-prescribe. We don’t tell them that we are going to e-prescribe the Rxs. We say, “We’ll call it in.’ They just assume that we just call the pharmacy and it is there by the time they get there. They don’t understand how the prescription gets there. As long as it gets there they are happy.”
Build a Better Web Site
If you build a better web site, will they come? For Dr. Birney, who already had a web site, the answer is a resounding, yes. “There is a template you can modify within the EMR and we forwarded our old URL to the new site under WRS. If you go to janicebirney.com it will reroute you to the WRS website. We loaded all the important things that were on the web site onto the new one. It states our hours and the insurance companies we take and there are some forms they can fill out. If they want to utilize it, it’s there for them. If they don’t, they can do it the old fashioned way,” said Sexton in his case study.
Scheduling is a Cinch
Like a pebble in your shoe, scheduling patients can be a nuisance. Dr. Birney, who sees 12 to 14 patients a day a few days a week also performs surgeries one or two days a week at a Surgical Center. “We like the integrated scheduler. Before we had two separate ones. It was a nightmare trying to collaborate between the two. It wasn’t really working. We would have somebody in the schedule who wouldn’t cross over to the EMR. We like that the scheduler is there and that it automatically generates a note.” said Sexton.
What physician hasn’t found it necessary to access a patient’s records when the office is closed for the day? “When Dr. Birney works from home or travels, WRS goes with her. She grabs a laptop from the office and heads off with it. Since everything is loaded in the ENT EMR, she swipes her finger and it logs her in; it’s not really hard for her to get around. She can take her work with her.”
Learning the ins and outs of an EMR before going live can be a drag on a busy practice’s daily workflow. To hear Sexton describe it in his case study, it was a no brainer. “The training was great. We basically had an outline of everything that Dr. Birney was going to use from WRS and we focused in on those things. One of them was surgeries. That’s a big part of her practice so we spent a lot of time on getting the surgery workflow down and learning how to do the codes and schedule them for two different locations. We learned about customizing, and entering in the CPT-ICD codes that she uses frequently, and prescribing. By the time we were actually going to go live we were fairly familiar with the system. It wasn’t a huge shock when we finally did go live. We have so many things that WRS recommended that really made it easier. The Digital Pen has saved us a whole lot of time and headache, especially when first starting out. With the Insurance Card Scanner you can scan the card and it goes directly into the patient’s chart under their insurance tab and it does the OCR (optical character recognition) on the card so it takes the image and generates actual text. It will populate primarily where to send the claim, the patient’s name, ID and group number so we don’t have to type any of that. It goes in there as well as the actual scanned image of it. If we had to print off the picture it is there too, in color. It saves us a whole lot of time. We just slide the card, take a picture and give it back to the patient. “
You’ve heard of power walking. Now meet power faxing. “Dr. Birney likes the WRS e-Faxing. With our new fax number, everything gets faxed directly into our ENT EMR so we don’t have to scan anything anymore. Before, with our old EMR, we had to scan, sign and retrieve. It would take forever just having it scanned in there. We just sign it to the patient now which saves us so much time. If we have a test ordered at a lab, we give the lab our new WRS Fax Number for the e-fax so the results get faxed directly to our computers. It doesn’t get printed off so we don’t have to take it, put it in the scanner, scan in and upload it. It just goes into the computer, which is great.”
Finally, Sexton may be a computer guru, but he’s certainly not glued to a screen all the time. He plays tennis (and played on a team with Dr. Birney’s son when he was in high school), he’s an avid photographer, and a golfer. Has WRS allowed him to play more tennis? “It does for me. I come to work and then I’m usually done by the time I have to leave. I don’t have to take work with me. I do a lot of stuff. It’s time to get out my skis,” he said.
Noting in his case study that Dr. Birney’s 88-year-old father is the oldest practicing physician (orthodontist) in Colorado, Sexton shed some light on the area’s demographics and how that equates to quite a heavy patient workload for a physician. “Littleton is not a bustling metropolis like New York or Chicago. But downtown Denver is a medium sized city for this area in the Midwest. It’s actually quite large. We’re 15 miles southwest of Denver in a suburb. Typically there are a lot of families with young children and also a lot of elderly. It’s a neighborhood suburb with a lot of single family homes here. There’s no a shortage of patients.”
Second Time Around
Now that the practice has said goodbye to its first EMR and has instituted WRS, it appears the adage, ‘If at first you don’t succeed, try again,’ is right on the mark. It is also noteworthy that WRS was one of the first EMRs Sexton found when he began his Otolaryngology EMR search. “Our search process wasn’t very long. I sent an e-mail saying I’d like more information and then WRS called me within the same day. That was nice. The representative (Chandresh) spent an hour talking to me about it. Then we set up a presentation the following week and in that time I didn’t really find any other EMR that met our criteria. And all the other EMRs I did find really didn’t compare to WRS. It was really a pretty easy decision,” concluded Sexton.