1. Health Information Technology Pinnacle Family Medicine Michelle Eads, M.D. Practice Setting Community solo practice Family Medicine One physician Colorado Springs, Colorado

2. Motivation for HIT Investment Starting Solo Practice Prior group practice ran inefficient paper based office Wanted to improve workflow efficiency, patient communication, service and care Knew modern office embracing technology would become the norm

3. HIT Implementation Began simultaneously with starting practice in 2003 Implemented integrated EMR/PMS prior to opening Offered email communication at opening. Added website with secure online evisit capability 1/2007. Approximate total budget for the project was $23,000 Software $17,000 Hardware $5,000 Professional Services $300 for internet set up Training included in software cost 6 people were involved from implementation to launch 2 in office – physician owner and IT husband (who built hardware) 1 vendor on site to install software 1 trainer on site 2 internet installers on site

4. Office Efficiency HIT investment has drastically improved office efficiency Workflow streamlined No hunting for charts – are always available, and no need for a filing clerk Prescription refills are a snap Signing off chartnotes, labs, etc. takes less time Timely communication with patients Slight initial decline in efficiency upon initial implementation as adapt to new workflow, building patient charts Improved office efficiency has a profound effect on patients Answer their questions quickly On-time appointments Improved disease outcomes

5. Getting the Most out of Your Investment Continue to evaluate workflow and HIT options New employees with computer experience get up to speed quicker, but still take time and patience Vendor offers online training sessions

6. Vendor Selection Knew I needed an integrated EHR and PMS, which quickly narrowed the field To find ‘the one’ I checked out the programs at national convention exhibits, visited sites with that software, and spoke with doctors using the product in a similar practice as mine Lessons learned and best practices Do not rush your decision Do not skimp on hardware Prepare yourself and your staff for the transition Understand your level of comfort and skill with IT Follow the vendor’s specs for hardware Double check verbal recommendations

7. Budget Determined budget by anticipated length of service and money saved by the product Costs contained by IT savvy relative building computers No overages Vendor has fixed monthly charge, includes upgrades and training (15-20% of initial investment/year)

8. Schedule Set monthly and weekly goals and tasks over 4 month timeline Checked tasks and progress daily to keep the project on time Internet installation delay, de-bugging software to work together Four months was a short timeline Upgrades and associated training occur q1-2 yrs, takes ~1hr

9. General Improved Patient Outcomes HIT implementation improved patient outcomes Track wellness and chronic dz data Know what to focus on for practice and individual patients Data instantly available for ER/specialist communication Improved pt treatment and outcomes

10. Condition Specific Improved Patient Outcomes HIT can improve care for patients with a particular condition Registry to track data Online pt survey to identify pts concerns and chronic disease education/understanding gaps Telephone and evisits improve access Benefits to the practice and patients Smooth workflow, improve efficiency, reduce waste Spend more time being a doctor for your patients Improved accuracy of documentation, billing and monitoring accounts receivable

11. Lessons Learned & Best Practices Determine what you want HIT to accomplish Realize many tasks should change with HIT implementation Use resources available to you Spend time observing the HIT in action to make sure it meets your needs

12. Contact Information www.PinnacleFamilyMedicine.com drmichelleeads@alteer.com

13. Suggested Resources www.centerforhit.orgwww.centerforhit.org Center for Health IT at the AAFP How We Improved Our Practice and Our Bottom Line With a New EMR System. Bradley M Block, MD. Family Practice Management July/August 2008 www.aafp.org/fpm/20080700/25howw.html www.aafp.org/fpm/20080700/25howw.html Why I Love My EMR www.aafp.org/fpm/20021000/35whyi.htmlwww.aafp.org/fpm/20021000/35whyi.html Computers www.aafp.org/fpm/20020400/57howm.htmlwww.aafp.org/fpm/20020400/57howm.html The EMR: Not Just a Computerized Chart www.aafp.org/fpm/20010100/08thee.html www.aafp.org/fpm/20010100/08thee.html Avoiding Common Pitfalls in Selecting an EMR www.aafp.org/fpm/classicstello.html Solo Physician’s Use of Virtual and Phone Visits, Same-Day Appointments, and Extended In-Person Visits Leads to High Patient Satisfaction and Improved Chronic Disease Outcomes. www.innovations.ahrq.gov/content.aspx?id=2196 www.innovations.ahrq.gov/content.aspx?id=2196

14. HIT Suite Alteer - EMR/PMS www.alteer.comwww.alteer.com Medfusion - website with evisit capability www.medfusion.netwww.medfusion.net UpToDate – EBM resource www.uptodate.comwww.uptodate.com Epocrates – medication and formulary info www.epocrates.comwww.epocrates.com Hows Your Health - patient survey www.howsyourhealth.comwww.howsyourhealth.com LogMeIn iPhone application to access server Microsoft Excel spreadsheet for registry Laptop with wireless internet card for out of office access

15. Outcomes example using HIT Enhanced PCCC % Having a PCP97.47 % Having Perfect Care77.22 % Having Very Easy Access72.15 % Having Confidence in self- management 69.23 % Seldom Wasted Time97.44 % Get Exact Care Needed67.95