WASHINGTON — When Dr. Joseph Heyman was starting his small private practice in Massachusetts in 2001, he knew there was no choice but to install an electronic medical record system.
“Electronic medical records were a must for me for three reasons,” Dr. Heyman said at a meeting on health information technology sponsored by eHealth Initiative and Bridges to Excellence. “Cost was the first because I did not want to hire a lot of people. Then there was efficiency, to make my job easier, and third was image, because I wanted to seem capable to my patients.”
Dr. Heyman, an ob.gyn., started with an initial investment of about $9,000 for two desktop computers, a scanner, and laser printer. He stored all his important information on the computers—patient records, contracts, fee schedules, billing—and things went well until a year later when disaster struck. The system crashed wiping out access. It took 6 weeks and about $15,000 to get back up and running. Four years later, it happened again.
Despite two major electronic mishaps in 5 years, Dr. Heyman maintains a paperless office. His patients have secure access to his Web site to make appointments as well as view and update their interactive health record. He even offers online consultations for a $15 fee, though “I rarely charge them,” he said. As part of the online consultation transaction, patients enter a credit card number for the fee; Dr. Heyman said that he only charges the card if he feels he really saved them the time and expense of an office visit.
Dr. Heyman said his performance has improved as well: He has eliminated the need for transcription services and improved his coding, and produces error-free legible prescriptions.
And what does he see as the best reward? “All the performance measures are great,” he said. “But to be honest, I wanted to spend less time in the office and make more money, and I've done that.” He added, “I used to see about 30 patients per day, now I see about 2 every hour. And my patients are happier because they have more time with their doctor.”
According to Dr. James Morrow, the physicians of North Fulton Family Medicine in Cummings, Ga., “didn't go electronic to be better doctors, we did it to survive.”
Dr. Morrow, vice president and Chief Information Officer of North Fulton, said the benefit of their EHR is all about time. The practice has been able to “save” about 44 hours per day or about 11,400 billable staff hours per year. He said it's equal to a time savings of more than $239,000 per year (based on 100 patients per day).
“We can now track quality of care at an outcomes level,” he explained. “We easily track HbA1c's, cholesterol, and blood pressure. And we receive reports securely, electronically, legibly, and much quicker from other hospitals.”