| When Dr. Arthur Lavin opened Advanced Pediatrics, he was dedicated to establishing a paperless office — a concept sought by many but achieved by few. In addition to implementing an EMR, he established a new office in a new building, hired new staff, and put into service new phones and billing software. |
“I remember the first day I started in medicine thinking the paper chart is bad. The data is inaccessible and reporting is nearly impossible. Data entry is redundant and inefficient. Imagine if you went to your bank and they had only paper slips from all of your transactions; it is amazing how healthcare has remained behind the curve when it comes to something as important as your health,” says Dr. Lavin.
As the EMR market began to mature a few years ago, Lavin began his search for a system by looking on the Internet and inquiring at the American Academy of Pediatrics (AAP). A short list of 6-7 vendors was chosen but he knew the process would not be easy. Before making a decision, the providers in his group anticipated they would have to look beyond the flashy sales presentations to assess how a system would conform to the way they practice medicine. Dr. Lavin explained, “With so many EMR choices, we made it our mission to find a proven system with the kinks worked out and with a stable company behind it. It was also critical to find a system that had been successfully implemented at other Pediatric specialty practices. We found what we were looking for in Integrated Healthware. They emerged as the leading vendor on our list.”
Advanced Pediatrics is now a showcase on how leading-edge technology can work to improve medicine. From the building design itself, which does not have a traditional paper chart room, to the computer software they use, they are clearly a leader among their peers.
In fact, the group has received recognition from no less than Microsoft and was chosen as one of only 15 small businesses in the country to be featured as part of the Microsoft launch of its new Office 2003 products. The office will be featured in a video and case study produced by Microsoft that will highlight how the use of computer technology can help a small business.
Dr. Lavin is quick to recognize that it takes a great supporting cast to make technology work. “The Integrated Healthware team assisted our staff on site for two weeks as we began using the system. Above and beyond the software itself, the setup and support of an EMR is paramount and is an area where many vendors fall short. We did not simply receive a user manual and a quick training session. The Integrated Healthware staff had a several month process laid out and it was clear that they had thought very carefully about how the process should go to be successful,” says Lavin.
To facilitate the implementation process, Integrated Healthware supplied a pediatric Starter Kit that met most of the group’s needs early on. With the help of the Integrated Healthware implementation team, the providers were able to modify the initial templates and workflow well before the live date. “I cannot say enough about the support and implementation team at Integrated Healthware. They have been incredible, and quick to respond,” Dr. Lavin stated.
The system has met his goal of making chart information easily accessible. Its greatest strength however, is its flexibility. He stated, “Depending on the situation, there are several options in how you can enter information in the system. A major reason why some physicians fail to embrace the EMR is that many systems are designed in a way that changes the way they practice medicine. The goal of an EMR vendor is to have the information in a database format but getting it there is not always in line with the way we provide care. The Integrated Healthware system does not change how we practice medicine. Rather, it supports multiple means of documentation and data entry,” adds Lavin.
The key is to have a good mix between database versus narrative ability within the system according to Lavin. “When a parent calls and says my child is not feeling well, what happens next cannot always be forced into a drop-down list on a computer, as many EMRs require. Or if a parent calls and says my child is having problems at school, they want to tell a story. The EMR should have the ability to handle multiple types of data input, text, and discrete data elements depending on what the situation warrants.”
Additional flexibility is provided by the Form Builder utility, which enables users to create custom encounter forms that look exactly like the paper forms that they currently use. These forms contain flexible pick lists for easily choosing diagnosis codes, procedure codes, medications, and laboratory orders. And, with the Quick Paths feature, providers can save valuable time by setting up information that they use repeatedly for a particular diagnosis.
“We’re even converting our old paper charts and saving them in the system. With a variety of flexible data entry options available to us, including scanning, this process is straightforward,” Lavin says. The office is clutter-free as there are no paper charts and the system does not require traditional PC workstations in the exam rooms. Each provider has a mobile, wireless computer that allows for unlimited mobility.
The group’s doctors say that using wireless computers enables them to be better informed before an exam, as they can quickly check lab results or other chart information as they are walking to the exam room. Additionally, they can see if there is an important call or message that might take precedence before the visit.
Lavin says this mobility extends far beyond the exam room. “Often I will receive a call at home from a parent whose child is not feeling well. They may assume I remember the entire history of their specific child. With the Integrated Healthware EMR, I have all the information available in seconds.”
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