Solo-Provider Practice and Rural Clinic Make the Switch From Paper Medical Records to EHR

Date: November 6th, 2012Category: CORHIO e-NewsletterTopics: EHRs, Meaningful Use, Regional Extension Center

The Colorado Regional Extension Center helps two more of the state’s practices adopt EHRs

Studies show that office-based medical practices are migrating to electronic health record (EHR) systems in record numbers. Practices foregoing paper medical records for EHRs are motivated by ARRA incentives and increased pressure from the Centers for Medicare and Medicaid Services (CMS).

Paper medical records pose challenges – like increased privacy risks and decreased efficiency. They tie up staff time, take up precious room to store, include hard-to-read handwriting and complicate patient recalls. The transition from paper charts to an EHR system can be challenging – especially for small and rural practices. But the increases in workflow efficiency, search functionality and the ability to scan and securely email are just a few of the benefits of EHR that make all the “pain” worthwhile. In fact, one of the first studies to evaluate the clinical value of EHRs showed usage was associated with an overall higher quality of care.

Health care providers all over Colorado areseeking guidance from trusted advisors at the Colorado Regional Extension Center to help them find the right EHR system and achieve Meaningful Use. To date, 723 primary care providers have attested for Meaningful Use in Colorado through the Center.

Solo Practitioner Embraces EHR After 29 Years of Paper Charts

The office of Joseph M. Lopez, MD, is run by three people who have worked together for 13 years. The Fort Collins solo practitioner has been serving patients since 1983. “We’ve had paper charts the entire time we’ve been in practice for 29 years,” said office manager and nurse Margaret Lopez, RN. “Our Medicare checks were getting dinged because we didn’t electronically prescribe. We can’t afford to take a cut so we knew we’d have to move forward with EHR.”

“We met with Ellen Batchelor from Colorado Foundation for Medical Care (CFMC) who walked us through all the steps – everything we’d have to do to get ready,” said Lopez. “If we had not had Ellen, we wouldn’t be where we are today. She was instrumental in keeping us moving forward.”

The team made the switch from paper to electronic in stages, including entering records and using features of the EHR gradually. “For us, a slow transition to the EHR was better. You have to expect a significant time investment and stick with it through the learning curve,” said Lopez.

“This is still a stressful thing in our lives, but we agree it’s a good thing. We’re glad we did it,” said Lopez. “We started with our EHR in May, we attested for Meaningful Use in July, and we got the check from the government in early October.”

“We stopped using a transcriptionist three months ago – saving us $900-$1,000 per month. We use less paper supplies to make the physical charts and many things are easier, like finding and printing reports when we refer someone to a specialist,” said Lopez. “The doctor thinks it’s easier to have messages going back and forth electronically vs. paper. And at some point, we’re going to sign up with the Health Information Exchange, which will eliminate even more steps.”

Rural Medical Clinic Receives Grant and Help From CO-REC to Adopt EHR

Eastern Plains Medical Clinic (EPMC) provides services to the rural community in Calhan, Colorado. Nurse Practitioner Renae Crawford took over the practice when it was at risk of closing 10 years ago. She turned the clinic around – growing the staff from four to 16 and building a new 3,000 square-foot facility in 2008.

Office Manager Penni Wilson has been with EPMC for 13 years and has seen it all.“We were a very manual system – on pen and paper. This created challenges with continuity of care and efficiency.”

In 2011, with a $50,000 grant through the Colorado Rural Health Center Care Grant Program in hand, they were ready to make the change from paper to EHR. “We worked with Angela Marino from Colorado Rural Health Center – she came out and did a site analysis to make sure we were prepared to go with EHR, what areas we needed to look at, how workflow was going to change and which policies and procedures we needed,” said Wilson. “Then we worked with Michelle Sturh-Bowes – she helped set up appointments for interviews with different EHR companies and worked with us on implementation.”

From start to finish, EPMC took three months to purchase and implement their EHR. “The whole process didn’t take that long at all,” said Wilson. “We were able to attest for Meaningful Use and our quality and continuity of patient care has improved. We’re better able to do quality assurance for patient care – to pull up people by diagnosis or specific health needs and recall them.”

“We’re really glad we did it, it’s definitely been a huge process, but we love it. We were a real team and we got through it together.”