During her residency at Providence Portland Medical Center in Portland,Oregon, Dr. Jane Dunham used a full-featured but complicated and expensive electronic health record (EHR) system. Next, she worked at a large group practice that had a partly electronic, partly paper-based system. She remembers, “We had to retrieve information from several different places; it was very piecemeal. That EHR was pretty dysfunctional.”
Looking For An Integrated Solution
When Dr. Dunham started her own practice, she knew she could do better.Working with a local EHR expert, she compiled a list of criteria and capabilities she needed:
- A single EHR and practice management (PM) system
- An interactive medication database with drug interactions
- A lab interface
- Patient tracking
- Interoffice messaging
- Billing capabilities that would allow her to manage her own practice
Efficiency Is Key In A Small Practice
Three systems met the basic criteria. After trying them all, Dr. Dunham selected Aprima. The single-application, single database manages EHR and PM functions. Efficiency is critical to Dr. Dunham. Her practice is small, consisting only of herself and two medical assistants. Aprima enables her office to function without any dedicated administrative staff.
More Flexibility, Better Health Maintenance
“Using Aprima, I can create notes easily without dictation,” she says. “The system helps us be as paperless as possible, with its interactive medication database, easy patient tracking, and powerful messaging features that give us easy access to the chart from the message window.”Aprima lets her practice the way she wants while building a financially successful business.
Part of the advantage Aprima brings to patient care is unexpected and very human: It enables Dr. Dunham to finish documentation and go home earlier, which means that she is more rested when she sees patients. “Aprima improves patient care because I’m not as fatigued, and I have more information,” she explains.
Aprima’s health maintenance features provide the doctor with the tools she needs to manage Well-patient care as well as chronic diseases such as diabetes. The system allows her to track preventive medicine such as vaccines, tests, imaging, and more.
Dr. Dunham says, “It’ s nice to look at the screen and say, ‘oh, you’re due for this.’ And if I order the test from the patient’s chart, Aprima automatically updates the corresponding health maintenance rule.” She appreciates the system’s flexibility in viewing rules or results for any patient, or all patients, and its integration with the Aprima messaging features. For example, Aprima can send a message to any designated person when a patient is due for a health maintenance service.
In addition, it is simple to run a report listing all patients due under a particular rule, or all patients assigned to that rule whatever their status.”1′m currently using that feature to bring all my diabetic patients up to date,”she says. “We generated a list of everyone who needs an AIC test so we can do a bulk mailing.”
Tailoring Documentation To Each Patient
Dr. Dunham also appreciates Aprima’ s flexible, template-free design with logical “trees” instead of rigid fields. This approach allows her to tailor documentation to each patient. “Most systems use templates that force you to answer a lot of irrelevant questions and show everything, whether you need it or not,” says Dr. Dunham. “Aprima makes it easier to see the information you need. Using it doesn’t interrupt the flow of a visit. If the patient says her symptoms started two weeks ago, I just tap “2 weeks ago.”
The unique customizability of Aprima even allows her to change drop–down choices during the visit. Dr. Dunham explains, “When you ask a question,you can add an answer right there, and then pick it and you’ re done. In some systems, that would take hours.”
The speed and flexibility of Aprima allow Dr. Dunham to complete 90% of her charting before she leaves the exam room. Back in her office, she takes another minute to add an assessment, perhaps a differential diagnosis. Then the documentation is complete and the visit is ready to be billed.
The Bottom Line
Efficiency and cost-effectiveness are critical to West Campus Internal Medicine, and Aprima has provided both. After its latest upgrade, West Campus took the plunge into electronic billing and remittance. Now Dr. Dunham completes superbills as soon as the patient leaves; sending out bills later takes an assistant only 10-15 minutes a day.
Claims are paid within two weeks, on average. Faster payments not only mean better cash flow, they reduce the number of collection calls the staff must make.
The practice uses its space efficiently. If it had to lease space for charts, Dr. Dunham estimates that she would have to lease an additional 100 square feet, which would equate to $2,100 per year in additional rent.
Dr. Dunham and her staff are delighted with their choice of Aprima. She says, “Doctors don’t need to be scared of going out on their own. With Aprima, you can practice the way you want, set your own rules, spend more time with patients, work less overtime, and incur less overhead. It can be so easy.”