Smooth transition,strong returnsA quick and cost-effective transition from paper to electronicmedical records helped Dubli...
SummaryDublin Primary Care, based in Colorado Springs, CO, is a medical practice withnine physicians dedicated to helping ...
Going electronic was worththe investmentPhysician-owned Dublin Primary Care was an earlyadopter of medical practice techno...
Implementation was fast and cost effective –with the right approach, attitude, partner,and productWhile practices are ofte...
Partnering with the right vendorincreased return on investmentMilburn reflected that partnering with an experienced andsup...
A powerful platform helps Dublin build its bestpractice now and in the futureDublin selected Centricity Practice Solution ...
© 2012 General Electric Company – All rights reserved.General Electric Company reserves the right to makechanges in specif...
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Smooth transition, strong returns - Dublin Primacy Care Case Study

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A quick and cost-effective transition from paper to electronic medical records helped Dublin Primary Care streamline staffing, improve care processes, shorten the revenue cycle, and prepare for upcoming payment reform.

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Transcript of "Smooth transition, strong returns - Dublin Primacy Care Case Study"

  1. 1. Smooth transition,strong returnsA quick and cost-effective transition from paper to electronicmedical records helped Dublin Primary Care streamline staffing,improve care processes, shorten the revenue cycle, and preparefor upcoming payment reform.
  2. 2. SummaryDublin Primary Care, based in Colorado Springs, CO, is a medical practice withnine physicians dedicated to helping patients achieve and maintain healthy,productive lifestyles. The practice is founded in the belief that high-qualityhealthcare requires personal and comprehensive services and the activeinvolvement of every patient. Clinical services include pediatric, adolescentand adult primary care, sports medicine, gynecological care, and minoremergency care.Centricity Practice Solution has helped the nine-physician Dublin Primary Carepractice cut costs and increase operating efficiency. The implementation wasfast and cost-effective because the practice took a positive attitude and choseovernight activation instead of a phased approach. In the future, leaders believethe software will continue to help the practice thrive through upcoming paymentreform. Deborah Milburn, administrator for the practice, based in ColoradoSprings, CO, notes, “What motivated us to move was that the world waschanging, and we felt that we needed to change with it.”The transition from paper to electronic records has:• Achieved one-year returnon investment.• Reduced FTEs by more thanone per physician.• Reduced days in accountsreceivable from 60-90 daysto 30-45 days.• Provided analytics thatimprove understanding offinances and patient trends.• Provided intuitive and practicaltools that help enhancepatient care.• Helped demonstrate improvedoutcomes for reimbursementnegotiations with payers.
  3. 3. Going electronic was worththe investmentPhysician-owned Dublin Primary Care was an earlyadopter of medical practice technology. Between July2002 and February 2003, Dublin transitioned its practicemanagement software to Centricity Practice Managementand adopted an early, separate EMR application. By 2006,the practice upgraded to Centricity Practice Solution, amore advanced, integrated PM and EMR software.Dublin Primary Care knew medical technology was animportant part of its long-term strategy. By acting on itsvision of the future, Dublin has seen numerous financialbenefits. Milburn reflects that adoption of an EMR in 2002“took away a number of headaches we faced with papercharting, like misfiled charts and illegible and incompletenotes. For example, in the paper world, a doctor might writeout a prescription and then get distracted and fail to put itin the paper chart. Now doctors enter the prescription in thesystem – the next time they see the chart, it’s going to be inthere. And we’re not having to call the pharmacy becauseonce it’s in the system, the prescription is already sent.” TheEMR reduced lost time that was costing the practice money.The technology also allowed Dublin to streamline clericalfunctions, helping to create a return on the investment afterabout one year, according to Milburn. In the paper world, thepractice had eight billers; in the electronic world it needs onlyfour because billing data entry is eliminated. The medicalrecords staff decreased from eight to two people, who todayscan information into electronic charts.A single, integrated databaseenabled further streamliningIn 2006, the practice replaced its first-generation EMR with themore sophisticated EMR module of Centricity Practice Solution.Milburn notes that Dublin’s selection of the integrated EMR andPM system had a number of benefits. “We were already withGE on the practice management side.” says Milburn.“The immediate advantage was that it put our EMR and PMsolution on a single database. With a single database, thereare no issues with interfaces between different products.We work with one vendor, and if we need support, we get itfrom one source.“A single database also improves coordination. There is nodouble data entry. In our registration process, we verify thatwe have the correct patient information. Once we have that,it runs throughout the system, so that anybody who needs orwants it can find it, whether in the chart module, scheduling,registration or billing.”The PM solution flags errors in insurance claims so that staffcan correct them before submittal. In addition, electronicremittance now automatically assigns payments to the properpatient accounts, greatly reducing payment data entry.Overall, going electronic and then transitioning to CentricityPractice Solution, allowed Dublin to reduce staff by morethan one FTE per physician – ultimately streamlining its FTEcount per provider to 3.67, well below the 4.87 median quotedby the Medical Group Management Association. In addition,days in accounts receivable dropped from 60 to 90 days inthe paper-based world to 30 to 45 days at present.“With a single database, there areno issues with interfaces betweendifferent products. We work withone vendor, and if we need support,we get it from one source.”Deborah MilburnAdministratorDublin Primary Care“We looked at other EMRs and foundthat GE was the best solution for ourneeds. Centricity Practice Solution isvery user-friendly.”Deborah MilburnAdministratorDublin Primary Care
  4. 4. Implementation was fast and cost effective –with the right approach, attitude, partner,and productWhile practices are often concerned that the disruptioncaused by going electronic may outweigh the eventualbenefits, Dublin’s experience shows that even small practicescan make the transition successfully without breaking thebank or the practice.“Flipping the switch” overnightaccelerated implementationWhile implementing its first EMR in 2002, and when migratingto Centricity Practice Solution in 2006, Dublin chose a rapidchangeover instead of a phased approach. The primaryreason was the additional cost to run and maintain twoseparate systems during the transition.When Dublin adopted its first EMR, “We were looking for zerocost impact to our practice,” Milburn says. “If you have anEMR, you no longer need to buy paper charts and dividersand shelves to house them. You no longer need staff to purgethe records every year and put them in storage. You no longerhave transcription costs. But for those costs to go away,you have to fully implement the new system. We truly useda ‘big bang’ approach. The doctors were willing. We justdecided to get everyone trained and just go live one morning.”A can-do attitude limitedimplementation obstructions“You need to approach it with the attitude that failure is notan option,” says Milburn. “My favorite expression is, ‘Everybodyis on the train, and nobody can get off.’ You can’t let anyonesabotage the implementation. If our doctors wanted tocomplain, that was fine, but they had to come into my officeand shut the door. And when that door opened, they hadto be supportive.”Implementation success was also linked closely to theconfidence of the personnel in the security of their jobsduring such a drastic change. The practice reduced staffwithout layoffs. “Your team needs to implement the changes,so you can’t have a fearful staff,” says Milburn. “We leteveryone know that no one would be getting a pink slip –that we needed everybody here to do this, we lost peoplethrough natural attrition and those positions werenever replaced.”Benefits experiencedby Dublin• No issues with EMR-PM interfaces• Single-vendor support• Improved coordination• Reduced data-entry• Faster claims processing“Centricity Practice Solutionmakes life easier for our physiciansbecause they have everythingat their fingertips.”Deborah MilburnAdministratorDublin Primary Care
  5. 5. Partnering with the right vendorincreased return on investmentMilburn reflected that partnering with an experienced andsupportive vendor made the implementation easier and moreaffordable. A GE Healthcare team led preparatory trainingclasses and stayed on site for three days after go-live to helpusers as they learned on the job. Initially, physicians stayedlate to fully understand the process of completing notes anddocumentation. Physicians kept their usual patient loadsand schedules so that revenue was not sacrificed during theshort-term transition. They soon learned how to documentas quickly as with paper charts.Lacking the financial resources for an in-house IT staff, Dublinhandled the IT side of the implementation with support fromGE Healthcare and a local vendor partner that handles thepractice’s hardware issues. “The relationship with GE has beenvery important,” Milburn says. “They support us on anythingrelated to the software and on any problem we can’t resolve.GE support people can access our system remotely, so theycan see what I am seeing, and I can then see what the solutionsare. That is very beneficial – it makes things happen quickly,and when you have an issue, that is what you want.”Intuitive software madeimplementation easierand more cost effectiveMilburn notes that “We looked at other EMRs and found thatGE was the best solution for our needs. Centricity PracticeSolution is very user-friendly.” The intuitive nature of the systemhelped the practice prepare its team for the technology withminimal training and make the transition literally overnight.In addition, Dublin purchased the Centricity Clinical Contentforms and used them “straight out of the box,” without tryingto edit them before go-live. “I think it’s a waste of resourcesto try to edit a product you haven’t used yet,” says Milburn.“It’s far better to use the product for a month or so, and thenbring your doctors together and let them all agree on whatthey like and don’t like. Then you can edit the templates, andyou’re all speaking the same language.”50% Fewer Days in A/RBefore going electronicAfter going electronic4.873.67 25%25% Fewer FTEsper ProviderMGMA MedianDublin Primary Care60-9030-45 50%
  6. 6. A powerful platform helps Dublin build its bestpractice now and in the futureDublin selected Centricity Practice Solution for more thanjust its near-term benefits. The aim was to find a powerfulsoftware platform that would help make the practice’sdecision-making smarter, so it could continue to enhanceits performance both financially and clinically over time.Strong analytics and intuitive,practical tools help Dublin continueto improve finances and enhancepatient outcomesAnalytics drawing on the data within the Centricity PracticeSolution database help physicians and staff extract detailed,actionable information in many areas: financials, patientvolumes and trends in diagnoses, among others. “We canask the what-if questions,” says Milburn. “It allows us to reallyget down into the detail of what’s happening in our practice.”For example, the staff can determine charges and paymentsfor the practice by payer and thus monitor payer balanceand keep tabs on collection percentages.Centricity Practice Solution also offers a number of intuitive,practical tools that help Dublin enhance clinical outcomes.For example, patient alert notes help Dublin communicateany information that all staff members need to know abouta particular patient – such as the fact a hearing impairedperson will need an interpreter. Reports on open ordersserve as a “tickler file,” making it easy for staff to identifypatients who need important preventive care, such as routinemammograms, and remind them to make appointments.With a user interface designed with extensive input fromclinicians, Centricity Practice Solution “makes life easierfor our physicians because they have everything at theirfingertips,” says Milburn. “That improves communicationbetween the physicians and helps them to provide goodcare.” Milburn notes that the system presents informationin organized and easily accessible formats, so that ifpatients want a medication list or an immunizationform, it can be printed quickly, helping them take moreownership of their care.Centricity Practice Solution is helpingDublin prepare for payment reformIn addition to helping Dublin reach its full potential as apractice, Centricity Practice Solution is helping the practiceprepare for and take advantage of upcoming changes in thehealthcare industry, such as payment reform. One powerfulfeature of Centricity Practice Solution is the ability to reporton clinical data. By documenting notes in reportable datafields, providers can later analyze care delivered and lookfor additional ways to improve outcomes.Dublin is a member of GE Healthcare’s Medical QualityImprovement Consortium (MQIC), which enables thepractice to benchmark its quality metrics against anationwide database of nearly 30 million de-identifiedpatient records and against widely recognized qualitystandards. In conjunction with MQIC, Centricity PracticeSolution facilitates the reporting of clinical data thatpayers increasingly demand.“Today, when our payers report quality measures, theyare using billing data, because that is all they have,” saysMilburn. “Going forward, they will want to know, for example,how many diabetic patients are within a certain level forA1C? How many have had a foot exam in the last year?You don’t get that information from claims data. You doget it from the EMR. That is what we’re working with themto provide, and MQIC is the tool we are using.”Centricity Practice Solution’s use of structured, reportabledata and standardized clinical terminology is helpingDublin not only prepare for the future, but also makethe most of it. The practice hopes to convince payersto increase reimbursement by sharing reports thatbenchmark Dublin’s quality of care information againstsimilar practices, and also by demonstrating that Dublin’spatient outcomes are improving.Parting WordsMilburn notes that it is feasible to choose the right EMRand implement it successfully. “Centricity Practice Solutionmakes life much easier. I can’t imagine any of our physiciansever wanting to go back.”Her final advice to physician practices implementing EMRand practice management solutions: “Do it right the firsttime. Keep your operational policies working well. Put yourproviders in the rooms so they can see the patients. Thenyour system just enhances the quality of everything.”
  7. 7. © 2012 General Electric Company – All rights reserved.General Electric Company reserves the right to makechanges in specifications and features shown herein, ordiscontinue the product described at any time withoutnotice or obligation. Contact your GE Representative forthe most current information.GE and GE Monogram, and Centricity are trademarksof General Electric Company.GE Medical Systems Information Technologies, Inc.,a General Electric company, doing business asGE Healthcare.xxx-xxxx-xxxGE Healthcare IT Solutions540 West Northwest HighwayBarrington, IL 60010U.S.A.www.gehealthcare.comAbout GE HealthcareGE Healthcare provides transformational medicaltechnologies and services that are shaping a new age ofpatient care. Our broad expertise in medical imaging andinformation technologies, medical diagnostics, patientmonitoring systems, drug discovery, biopharmaceuticalmanufacturing technologies, performance improvementand performance solutions services help our customersto deliver better care to more people around the worldat a lower cost. In addition, we partner with healthcareleaders, striving to leverage the global policy changenecessary to implement a successful shift to sustainablehealthcare systems.Our “healthymagination” vision for the future invitesthe world to join us on our journey as we continuouslydevelop innovations focused on reducing costs,increasing access and improving quality around theworld. Headquartered in the United Kingdom,GE Healthcare is a unit of General Electric Company(NYSE: GE). Worldwide, GE Healthcare employees arecommitted to serving healthcare professionals andtheir patients in more than 100 countries. For moreinformation about GE Healthcare, visit our website atwww.gehealthcare.com.

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