I would like to talk this week about EMR systems. As many of you know, I became intimately involved in the creation of an EMR system several years ago. Why would I want to do this? Didn’t I know that there are already too many EMR systems on the market? How could I hope to compete with the “big boys” like GE? Why don’t I just find a good system and “push it” to my clients and make profits that way?
I’d like to take the next few minutes to tell you why. Anyone that has listened to me over the last few years knows that my office works well because of efficiency. If patients are being seen late, let’s find out why and fix the problem. If our phones are always busy, let’s put in more phones. If I come out of a room and can’t find a nurse, let’s hire more nurses. If we are putting off patients until tomorrow instead of seeing them today, let’s fix it.
When I go see the doctor, I don’t want to wait even 15 minutes past my appointment. If my child is sick and I call that morning, don’t tell me it’ll be 3 days before I can get in. If I want to talk to a nurse, don’t take a message and then 2 days later call me back. And if my wife tries to call her doctor at 4:00 (this happened last week), don’t put me through to a message that says “we don’t answer phone calls after 3:30.”
As a physician, I consider my duty to my patients is to provide them with comfort, compassion, education, health, and healing. Actually very little of what I do heals patients. That’s mainly up to God. Sometimes medicine helps. But the first 3, comfort, compassion, and education is what I do all day every day. Sometimes I can help fix their problems. Sometimes it’s a virus. But every time I see a patient is an opportunity for me to provide them with comfort, compassion, and education. And everything in my practice is geared toward that end.
That includes all my staff, my scheduling, my equipment, and even my billing. We can’t stay open if the bills aren’t paid. The reason I buy anything or employ anyone in my clinic is to help me see patients better or more efficiently. And that includes my EMR system.
Many companies loudly proclaim how their system “improves patient care by reducing errors.” So what! Every EMR system does that. So once that is out of the way, then what? I’ve looked at most of the best-selling EMR systems out there. They will help you write more detailed notes. Take bigger histories. Track labs and x-rays. Schedule patients. Do billing.
But every system I came across had one thing in common: They all made my life harder! That’s right. Compared to paper charts and dictating, every single EMR system created more work for me. As a busy pediatrician, the last thing I want is more work. On busy days when I see 60 patients between 8:00 and 5:00, I’ve got about 1 minute per patient to do charting and paperwork. The other EMR systems I’ve seen would have increased that to 2-3 minutes per patient just to write the note! That means an extra 1-2 hours at the office! No thanks.
When I started creating my EMR system 12 years ago, I had one goal in mind: Make my life easier. This could be by saving me time when writing notes, or making it easier to find the particular test or result that I needed. But everything in my system was designed around that one goal.
Over the years, it has progressed from a simple “progress note writer” to now including drugs, interactions, allergies, tracking procedures that are due, scheduling, flagging of important referrals/x-rays/lab tests, messaging between staff, clinic flow, plus 30 other things. But always, every time a new feature is added, it is for one purpose: Making life easier for everyone in the practice. Not just the doctors, but also the staff and the patients.
We’ve been running the beta version of our EMR system in my office now for 3 months and I can say it more than anything else allows me to see the volume of patients that I currently see. I’ve timed it: When I get behind and have to do several progress notes, it takes me on average about 30-40 seconds per note to get them done. It is actually faster than dictating now. That is why I created my own system.
Here’s a good example: Over the past 3 weeks, here in Elk City we have had a significant influenza outbreak. We have had over 250 positive flu tests in the last 15 working days. In my small clinic of 5 exam rooms we have averaged 108 patients per day for the last 15 days. Yesterday morning was a typical Monday. I had 9 patients scheduled between 8:00 and 9:00 (like I usually do). I jumped in and went to work.
I found out within a few minutes that something was wrong with the network. The program and computers were working fine, but some kind of network traffic issue was causing problems. My IT guys figured it out within about an hour, but during that hour we had trouble using our EMR system. The result? By 10:20, I was running an hour behind!
The moral of this story? On my own, it is impossible for me to see 9 patients per hour. Without the system, I can see 6 patients per hour. With the system, I can see 9. That means in my practice, seeing patients 22 hours per week, my system allows me to see an extra 66 patients per week, which translates to an extra 3300 visits per year for an increased income of $264,000. And that is just me. Once you figure in what my nurse practitioners are doing, that number goes up even more.
That is why I designed and created my EMR system. To make my life easier.
Our program used to be called “Project Tiffany.” However, we received a letter from the Tiffany Co. in New York that said no one can use the name Tiffany without their express permission and if we continued to use it we would be sued, put in jail, drawn and quartered, and possibly have to give up our firstborn child. So to be clear: we are no longer using that name and the Tiffany Co. has no affiliation with us or our products. So now we have to come up with a new name.
I thought about calling it Microsoft Word or Google. But evidently, these names are taken also and the lawyers say we can’t do that. We are doing trademark searches right now for our new name and as soon as it ‘clears’ the process, we’ll let you know.
An exciting piece of news for us is that we are now in the process of installing the system in about a dozen different offices. Once we finalize this last stage of testing in several different settings (primary care, specialists, and surgeons), we will be bringing the system to market. We’re very excited and will love to share more information with you over the next few weeks. I will keep you all posted about more pieces of the system that we’ve designed. Hopefully you will find that it truly does make your life easier.