Tapping into IT to Improve the Office-Based Practice

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Information technology infrastructure, especially the electronic medical record (EMR), does deliver. Consider:

  • An EMR trims operating costs. According to Medical Group Management Association (MGMA), it costs $4.50 each time a patient calls and a staff member must pull a chart. Cardiology practices must multiply the $4.50 figure by upwards of 10 to 20 calls daily.
  • Say goodbye to transcription costs. That’s about $12,000 per year per physician. And the practice can reduce medical records FTEs.
  • Think revenue increase. The EMR facilitates better coding, which translates into a 5 to 12 percent increase in reimbursement for office visit. The primary reason? Many physicians are afraid to code an office visit as a level four, but an EMR contains the data to support the higher-paying code.
  • The EMR delivers improved risk control. Charts aren’t lost; they can be accessed from home or another office location. Plus, electronic records provide a more complete picture of the patient, helping cardiologists avoid patient safety errors like drug-drug interactions.
  • An EMR is a stepping stone to better relationships with patients and improved service. Patients don’t need to remain on hold for five to 15 minutes or longer to secure a prescription refill.
  • Electronic charts help physicians regain time. Cardiologists in EMR-equipped practices can end the work day sooner than colleagues chained to paper charts and transcription. They also can see more patients each day, and document patient encounters more completely. And of course, the data can be mined in easy to create reports to recognize trends in the practice.

The upshot? The EMR and other investments in IT infrastructure represent a winning scenario for office-based cardiology practices. As practices transition toward an EMR, they need to look beyond software and consider questions about hardware and staffing, too. Insiders can provide a wealth of information about the benefits and do’s and don’ts of IT infrastructure and steer their colleagues toward a smooth implementation.

Inside an IT pioneer


The Medical Group of Southern California (CVMG) is a health IT pioneer. Ten years ago, the Los Angeles-based practice was one of the first medical groups to launch its own website. The website paralleled another important IT development: NotesMD, a homegrown, web-based EMR. The premise behind the practice’s online efforts is simple. Physicians are the knowledge workers of the healthcare world, says Ronald Karlsberg, MD, clinical professor of medicine at David Geffen School of Medicine UCLA. “They need patient information and unlimited resources,” states Karlsberg.

At CVMG, NotesMD is the vehicle for transmitting knowledge to the physician. The server-based system has become an indispensable tool where cardiologists view lab results, general knowledge and patient charts. An integration with McKesson Corporation Horizon Cardiology allows physicians to view images in the patient record. The practice reduces the bandwidth stress associated with hefty file sizes of studies like cardiac CT angiography by creating summary images in a PDF format and compressing moving images beyond normal ranges. On the reporting and documentation sides, NotesMD minimizes note taking and typing and can generate all reports from dictation.

NotesMD allows CVMG to capture 95 percent of patient data, compared to 40 percent in most practices. Prescriptions are refilled with a single click, not only reducing errors, but also increasing efficiency. Other cost savings come on the staffing side. For example, the solution enabled the practice to transition from one transcriptionist for three to four physicians to one transcriptionist for 16 cardiologists.

On the hardware side, the web-based product can run on any device such as a PDA, iPhone or Tablet PC. CVMG opted for hardwired secure workstations in all exams rooms to provide a stable, dedicated workspace at the point of care.

EMR upgrade makes the grade


The first time is not always a charm when it comes to technology—particularly for early adopters. Take for example South Florida Cardiology in Pembroke Pines, Fla., an 18-cardiologist practice that first implemented the EMR in 1997. The impetus for the first project was improved documentation, not enhanced efficiency, says partner Perry Krichmar, MD. “Without proper documentation, it can become problematic to secure reimbursement for tests.”

The initial system performed as expected; however, as costs increased and reimbursement