The Struggle with EMR-One Practice's Story

Physician's Money Digest, October 2007, Volume 14, Issue 10

Is health care old fashioned? In the age of ATM banking and Internet commerce, it is surprising that the most critical and personal of all industries is years behind the curve in automating its old paper processes. Just over 10% of US physicians use the latest technology, electronic medical records (EMRs). That means 90% of American doctors still rely on handwritten paper notes to track patient visits, order and record medications, read test results, and otherwise ensure a patient will get the best possible care.

Unfortunately, paper medical records require a great deal of space to store, and they take time to retrieve when a patient contacts a physician for care. Paper records are also subject to damage from fire and water, and due to the volumes of paper involved, no back-ups or copies are maintained in most cases.

A Change for the Better

When the 37 physician-surgeons of Pinehurst Surgical moved into our new facility on July 17, 2006, we joined the cutting edge of American medicine by adopting an EMR to eliminate paper charts from our new offices. With this innovation, Pinehurst Surgical is positioned to deliver an even higher level of service than it has for the last 60 years.

What’s the secret of the EMR? Simple: It leverages the power of computers and the Internet to provide information when and where it is needed. For example, if someone seeks medical care after hours, they will likely reach a physician working on-call from home. Because on-call doctors cannot access paper charts when they are out of the office, they rely on ill patients or stressed loved ones to provide medical history over the phone. Lab results and imaging studies are not available for consideration. Even with the most professional physician, it’s clear this approach leaves room for improvement.

With EMR, on-call physicians can use their home computers to securely and instantly access any patient's complete medical record. Even in an emergency situation, accurate medical information is available, which vastly improves the care that can be provided. Similarly, doctors visiting patients in the hospital can call up their medical records on handheld tablet PCs. And no matter where they see a patient, Pinehurst Surgical caregivers can use the EMR to document their visit, instantly record the patient’s problems and their diagnosis, order tests or review lab results, and prescribe medications with the aid of automated alerts that warn of unsafe drug interactions, improper dosages, and patient allergies.

Preparing for Evolving Trends

These types of efficiencies are critical to maintaining a quality health care system. Physician groups like Pinehurst Surgical are struggling to cut rising expenses wherever possible. The cost of operating a group practice rose by nearly 18% between 2000 and 2004, according to the Medical Group Management Association, while physician reimbursement for treating Medicare and Medicaid patients fell by more than 15% during that same time period.

To counteract these devastating trends, it's time to turn to technology. Before the EMR, each physician required significant support staff to create, file, and pull paper medical charts. But the new, EMR-powered facility added seven new physicians without adding a single support person for chart-related functions or transcription.

The EMR system also will soon enable the office to offer innovative new services that will enhance the quality of care patients receive and make it easier for them to get in to see a physician. With instant access to patient information, including imaging studies, Pinehurst Surgical will begin to offer "open scheduling." The goal is for patients to be able to make an appointment and be seen by their physician on the very same day—often within hours of their call. And with full system implementation, eventually patients will be able to access their own medical records online, request appointments or prescription refills, and get personalized care programs delivered right to their email in-boxes. Eventually, established patients may even be able to consult with their doctor online, without visiting the office.

Pinehurst Surgical physicians have faithfully provided medical care to the Sandhills community for some 60 years, and their top priority has always been to deliver high-quality care. Today they step boldly into the 21st century of medicine with new technology and a renewed focus on greater efficiency and lower costs. Most importantly, the physicians are now armed with the technology tools they need to provide quality care and instant access to patient information. Phyllis Schuck is the Chief Information Officer of Pinehurst Surgical, a multispecialty practice comprised of nine specialty centers and 37 physicians in Pinehurst, NC. Ms. Schuck was formerly the group’s Chief Operating Officer and project manager for its electronic health record implementation. She has a combined 25 years of experience in both software and health care management. The systems utilized by Pinehurst Surgical are the TouchWorks Electronic Medical Record System from Allscripts and Allscripts iHealth services.