NP Serves Expanding ENT Patient Roster with WRS
When Denton Combs, CNP left an ENT practice where he had worked for six years and started his solo ENT and allergy practice he was glad to have his own business. However, there was one obstacle that was standing in the way of his efficiency.
“For the first seven months, we had Practice Fusion, which is a free EMR. I hated Practice Fusion. We were having major trouble with billing and getting everything through. I hated that the business aspect and patient control aspect were not on the same side as the EMR. All of our billing was separate. Nothing was tied together. We were waiting to make an error and then having to redo that error,” said Combs.
Combs treats patients of all ages, for a myriad of conditions, including chronic reflux, chronic ear and sinus problems, as well as allergies. Pointing out that NPs in South Dakota work collaboratively with physicians, Combs said that he diagnoses chronic and acute diseases, initiates therapy, manages chronic subsequent therapies, and interprets diagnostic tests.
“I was looking for an EMR that was already tailor made for ENT and allergy,” said Combs, who evaluated 10 EMR systems before selecting WRS.
Pointing out in his review that a physician he had previously worked with uses WRS, Combs said, “He likes WRS, so we looked at it. WRS already has everything integrated into the system, including a Billing Module and a clearinghouse, so it’s tied together better than other EMRs. My nurse and I liked the whole WRS package the best, including the modules. Everything about the EMR system interacts wonderfully so you don’t have to exit out of one program to go to another.”
Combs continued, “With all of the other EMRs there’s a billing side, a check-in side and an EMR side. They were all tied together, but you couldn’t be in them simultaneously without having to close one down in order to open the other up. WRS is so convenient.”
Having prematurely met his seven year practice goal in just 18 months, Combs has attracted about 1,100 new patients. With 65 new patients added in just one month, it’s easy to see how WRS Patient Portal is helping Combs and his staff work more efficiently.
“I’m running everything. I’m doing the accounting and billing. My nurse and Medical Assistant talk to patients about them having access to their records and getting all the documents online. Patients are entering the information on the patient portal before they come in.”
Although patients over 55 years of age are not yet embracing the patient portal, Combs is very pleased with the 20% of patients who are entering their information in the portal. “That is making our life a lot easier,” said Combs.
When it comes to billing for his ENT practice, Combs is breathing easier. “We are using WRS Billing Services and Billing Module. I like that it is all tied together. I pay for someone to audit my charts every six months and I’ve been doing very well. Right now we get five rejections a week. That’s a low number,” said Combs.
No novice to entering billing codes, Combs said, “I’ve been doing coding for 12 years, so I already know what should come up. If it doesn’t, WRS gives you a suggestion. WRS ENT EMR tells you if you are missing things, such as one element of the exam. If it comes up wrong then I know I must have missed ‘this or that’ so I just fix it right away and it is done.”
WRS e-prescribing capability is also helping Combs’ staff to be more efficient. “E-prescribing keeps my nurses off the phone and keeps everybody answering the right questions. Instead of talking to the pharmacists, we just send the Rx. E-prescribing cuts down on my phone calls too and patients like it,” Combs stated.
All Weather EMR
With blizzards being commonplace in South Dakota, having an EMR with unlimited accessibility is imperative. “Accessibility is a huge thing because we have several days here where they close the interstates because there’s 30 inches of snow and 50 mile per hour winds. Patients obviously won’t come in a blizzard. With WRS though, you have all of the tools to call them from home.”
Combs and his staff also depend on WRS accessibility even when the sun is shining. “My nurse and Medical Assistant take a laptop home with them even on normal (weather) nights. Sometimes they pull things up and look at pharmacy recalls at home. Then they can call the patient or send me a message saying, ‘Check out this request.’ They will call and if they have a question they just text me or email me, then I pull it up on the system myself and look at it,” stated Combs.
Being able to plan ahead is a win/win for Combs and his patients. “Every night before I go to bed I always look at my schedule for the next day. If I have 22 to 25 patients scheduled, I’ll review all their charts and labs in order to make sure I’m ready for them. The nurse and M.A. check from home to see if there is an email question through the WRS Patient Portal.”
Combs added, “We have WRS set up on auto recall whenever I’m supposed to see patients next. It’s set up so many days in advance and it calls or emails patients, whichever they prefer, to remind them they have an upcoming appointment. This feature keeps us off the phone and from having to do menial things when we should be talking to patients and answering their questions.”
Affordable and Friendly
Noting in his review that WRS ENT EMR was very affordable, Combs said he opted to pay for one-on-one training. “The training WRS offered was good. It was also very personable. Our training was scheduled for an hour and we were done in 20 minutes. We did it all over the phone. WRS walked us through the whole process of showing us how to do things. The first time we talked we had already put 200 patients into the computer without any training. WRS is very easy to use. It’s all in order of how you want to do it. When we call or email, we get a response back from WRS right away.”
Fax Queue Saves Time
Lab connectivity is another time-saving EMR feature that Combs is banking on to help him with his workflow. “It helps us because the (lab) report goes right into the lab section on the date it was sent versus it having to be scanned in and then assigned into the chart. WRS Fax Queue allows you to fax and do everything without making copies. You can pull in the whole record for anything that you want and assign it electronically. The Fax Queue saves about three steps: getting the report, scanning it back in and assigning it, or pressing and faxing it and then getting a record that it was faxed.”
ENT And Beyond
Aware that WRS was designed by an ENT physician, Combs said, “Knowing that made me think that the EMR was going to be good for ENT, but I think it’s good in other places too. I’m a family NP so I can deliver babies and I can do family practice. I treat a few older patients who wanted me to take over all of their care. I also have 20 diabetic patients and 50 patients with cholesterol issues who want to use me as their primary. I use WRS EMR to help these patients as well. Some of my patients come from 100 to 400 miles away. South Dakota is very rural. In the whole state we have 710,000 people,” said Combs.
Taking a Breather
With a plethora of year round recreational offerings right in his backyard, you can’t blame Combs for wanting to get outdoors. “I’m a huge hunter and fisher. I hunt for deer, antelope, elk, pheasant and quail. My kids are 15 and 16, so even though I’m a business owner, I try to spend a lot of time with them. We go water skiing, tubing and parasailing. We fish all morning and ski all afternoon. In winter the ice gets to be over 3-feet thick and we’re out fishing. I take pictures for high school football, and wrestling, so I get out early every day there’s a meet or a game. I wrestled in college, now my son wrestles and that takes up a lot of time. I can be a passenger in the car, find a hotspot on my phone and do my charts from wherever,” he said.
Building for The Future
Judging from Combs’ description of how he literally built his office from scratch, it’s apparent that he intends to please patients for a long time. “We tore the building apart last April. It was in a seven-year-old building, built in triangles with conference rooms, and it had no running water. I renovated it all myself. I had nothing to do with the decorating though. I call it plum, the office staff calls it purple. It’s got beautiful front end tile work. There’s a grey overtone on the carpets and contrasting wall. The lighting is very pretty. We have silver chandeliers,” said Combs.
Acknowledging that he never thought about opening his own practice when he was in medical school, it’s apparent Combs made the right decision. “I had no idea I’d expand as fast as I have. I’ve always been an entrepreneur. I also have a 100-acre farm. I won’t be able to handle more than 1,300 patients or I’ll have to expand and get a partner.”
Finally, does Combs credit WRS ENT EMR for helping him to successfully handle his rapidly growing practice? “Yes,” he quipped good-naturedly, “I’m glad.”