If you think electronic medical records (EMRs) are for large, profitable practices – not small, rural ones – Southern Indiana Community Health Care may change your mind.
The non-profit family medicine practice has four physicians and four locations in rural English, Marengo, Paoli and French Lick. The staff now enjoys a fully functional EMR and would “put up a fight” if they had to go back to paper.
They have experiences and advice to share; however, Matthew Waldron, M.D., noted that many of the “so-called advantages” of EMRs are not reality. “It won’t make you faster and won’t save you money,” he said. “If you were disorganized and always behind schedule before EMR, you’ll continue to be that way.”
Why make the move? “EMR has portability and accessibility. I can read patients’ charts at any office location and log in anywhere I can get Internet access,” Dr. Waldron explained. “There’s a level of flexibility you just can’t have with paper charts.”
The beginning
In 2004, the practice took advantage of opportunities that came along, including Doctor’s Office Quality Information Technology or DOQ-IT, a national quality improvement program that assisted physicians with acquisition and transition to EMR.
The practice also shared in Bloomington Hospital’s Health Resources Services Administration grant in 2006, which offered funding for practices to improve services in whatever way they chose.
Southern Indiana Community Health Care wanted to connect its four locations and integrate practice management and scheduling with any EMR system. “One representative did a great job of presenting and made everyone enthusiastic about her product,” said Dr. Waldron. He championed the project – and having a champion is important to the process.
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| Southern Indiana Community Health Care, Lindsay Lira, M.D., used health information technology during her training, but not e-prescribing. "It's as simple as using e-mail," she says. |
Most of the staff learned quickly, said Janie Millspaugh, practice administrator. “Some older staff members were slower to adapt, but everyone exceeded expectations.” Millspaugh noted one physician was resistant, but rather than single him out with extra attention, they left him to adapt at his own pace. Eventually, the system earned his respect.
Going live
Dr. Waldron devoted many hours to formulating templates and drug lists. He went live with the system first at his location; months later the others joined. The practice never scanned all their charts, but physicians would flag medical records they wanted scanned into the EMR. Some histories or test results about past medical problems and X-ray results were imported to the new system.
“I carried a paper chart along with me to patient visits for a while for security,” said Yolanda Yoder, M.D., “but I quickly gave that up.” The doctors now carry notebook computers with them room to room.
Dr. Yoder came to appreciate the ability to access patients’ charts even when patients didn’t visit their regular office. Another benefit of the EMR, said Dr. Yoder, is the medical management capabilities.
“I can print out a copy of a prescription list and create a plan for the patient,” she said. “Then the patient is able to leave the office with a good understanding of their meds. It’s a safety issue for me.”
The physicians build a problem list containing each diagnosis and how it was treated in the past – sequentially by date of visit. The lists are “a favorite feature.”
| Southern Indiana Community Health Care names some benefits of EMR |
- No need to look for Rx pads with e-prescribing
- No transcription costs
- No searching for lab results
- No lost charts
- Medical records accessible from home
- Reduced storage needs for paper charts
- No staff time for pulling/filing charts
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Today’s office
Recently, Health Care Excel, Indiana’s Medicare quality improvement organization, identified Southern Indiana Community Health Care as a national model. A representative from Sen. Lugar’s office visited the practice to observe their success – at this key time when the stimulus bill (American Recovery and Reinvestment Act) promises new opportunities to move toward EMR adoption.
The physicians and staff welcome your questions and invite you to visit and see their EMR in action. Call them at (812) 723-7997 or e-mail them here.
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