Dr. Carmen Doty-Armstrong of Blanchard Valley Women’s Care started researching electronic health records (EHRs) in order to save space and eliminate the need for paper-based charts. The practice had originally opened using a well-known practice management (PM) system. When the group decided to add an EHR, they evaluated the PM vendor’s EHR, along with about six others.
Why Aprima?
Aprima was ultimately the winner for its flexibility, adaptive learning capability, messaging, and billing and collections tools. Dr. Doty-Armstrong, Dr. Lorie Thomas, and the physician’s assistants have very different documentation styles; Aprima was easy to customize so that it suited each of them.
Blanchard Valley Women’s Care took an unusual approach to implementing its Aprima EHR solution: charting contests. Training began in January 2005. Practice Manager Karon Kujawa explains: Rather than closing the office or seeing fewer patients when they were learning to use Aprima, the practice’s two physicians each picked one visit a day to chart electronically. Soon, they were doing two, then three visits a day, and pretty soon the doctors were racing to see who could document the most visits with Aprima. “It got competitive,” Kujawa remembers.
At some point, though, it was time to cut the strings and get rid of paper entirely. The perfect opportunity arose when the practice reached the bottom of its box of customdesigned blank charts. “It would have cost about $3,000 to place the minimum order.
Not having to buy any more charts was the perfect incentive to finish the transition.” The practice went live on the complete Aprima EHR and PM in February. “Aprima seemed very user-friendly when we were evaluating systems, and it has proved over time that it is,” says Kujawa.
“We have a staff member who, at that time, had just joined us from another practice. She had never used a computer there,” Kujawa continues. “Now she’s a champ on the Aprima system. It was painful the first few weeks, but as her confidence grew, she became proficient.”
Speed Is Vital
The two physicians chart differently, partly because they have different kinds of patients. However, being able to document patient visits quickly is important to both doctors and all the other clinicians at this fast-paced office.
With so many kinds of providers—physicians, midwives, and physician assistants— Aprima’s flexibility and adaptive learning have proven to be its biggest assets. “Adaptive Learning” is a feature that enables Aprima to automatically adapt menu options and other preferences to each person as she uses the system, without requiring special programming or other IT involvement.
Providers can design a “common problem palette” for different types of visits, easily
setting defaults without the constraints that would exist in a template-based EHR. The
providers can click in just a few places and focus on questions that are relevant to the type
of visit. Charting in Aprima is fast and complete.
Kujawa says, “The flexibility of the system is phenomenal. It’s just a matter of finding what
works best for each person. You have all those options, so you’re not stuck with one specific
way of doing things.”
Importance Of A Solid Practice Management Application
Outside the exam room, the rest of the staff appreciate how much easier Aprima makes it to keep the practice on track. “We certainly spend a lot less time looking for charts,” Kujawa says.
The phone nurses find that Aprima allows them to handle patient calls more efficiently. When a call comes in, the nurse can pull up the chart on the spot, answer a question, and send a message to the provider such as a refill request. When a patient calls with a postoperative concern, the nurse can write a quick message, tag it “urgent,” and send it to the provider for a quick response.
Blanchard Valley Women’s Care has also seen a big financial improvement after installing Aprima. That improvement begins with coding. First, Aprima suggests appropriate codes to the doctor based on the patient record. Second, the system ensures that the record contains adequate documentation to support every code. The biller can easily doublecheck to make sure that a particular code has been validated, a “huge advantage” according to Kujawa. Bills go out two weeks faster withAprima than they did before.
“I love, love, love the collections module!” says Dawn Bouldrey, the biller at Blanchard Valley Women’s Care. Aprima makes it much easier for her to track collections and catch underpayments. Recently, the practice had four deliveries that were underpaid. She caught the errors right away. Bouldrey had to argue with the payers, but got the claims paid as they should have been.
Aprima’s “Insurance Promise” function is a key part of the collections toolbox she uses. It provides a dashboard, essentially a tickler, that helps billers keep tabs on the promises that insurers make about paying claims.
Flexibility in scheduling is Kujawa’s favorite part of the Aprima system. Users can divide the screen into 3, 4, or 5 different screens showing appointments, message logs, noshows, and more. Kujawa says they are discovering new capabilities all the time. “We had a wonderful practice management system before. I didn’t think I’d like anything as well.” Combined with the doctors’ experience with Aprima’s EHR, Kujawa’s concludes, “Aprima is even better.”