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It Takes Two to Tango


By Bill Briggs, Senior Editor January 2005

For Primary Care Associates, the sum of its practice management and electronic medical records systems is greater than its parts. But the parts aren't bad either.

The 25-physician group implemented a practice management system in June 2002 and will roll out an electronic medical records system this month. The practice management software was a giant leap beyond the previous DOS-based system and improved claims management, revenue tracking and patient scheduling, says Bo Greaves, M.D., a family practitioner and president at the Sonoma County, Calif.-based practice.

It will be the electronic records system, though, that widens access to patient data, enhances practice patterns and ends the group's dependence on paper.

"So much of what we do in the paper world is repetitive," Greaves explains. "We ask for the patient's name and date of birth over and over." Soon, all such data will flow from Primary Care Associates' practice management application into its electronic records system.

Helping the provider

"And it will migrate back to the physician's note," he adds. "That will help the provider determine the appropriate level of coding. Data then returns to the practice management system and drops into the claim."

Primary Care Associates is among a small but growing faction of group practices that believe these two applications together can improve patient care and operating efficiency. They also believe these information technology tools will become status quo in the new world of performance-based patient care contracts and reimbursement.

What these groups seek is access to information, which will improve operating efficiency, charge capture and patient care, says Rosemarie Nelson, senior consultant at Medical Group Management Association, an Englewood, Colo.-based trade association for group practice administrators.

"A paper chart just can't be made more accessible," Nelson says. Physicians complete nearly a third of all patient encounters without a patient's chart in-hand, she notes. "The chaos of the paper chart is a huge driver. It's the one thing people want to fix."

Data culled from a March 2004 MGMA member bi-monthly survey indicated that 27% of 355 responding group practices had electronic health records systems in place.

Improving care quality and documenting results are key factors for providers who implement both practice management and electronic records systems. Plus, electronic data can be searched easily, a critical factor in last year's recall of the Vioxx pain medication, Nelson says.

Mind over paper

Group practices also run more efficiently with the twin applications in place, experts say, enabling many to eliminate or reassign labor. "Reassigning office staff means people get to take on roles with higher responsibility," Nelson explains. "There is no longer so much mindless paper-pushing. With more access to information, people are working at a higher level, providing more value and better service."

Nelson notes that group practices have shown increasing interest in electronic records systems in the past 18 months. "I've worked with a lot more groups who went from the system-search phase to selection, and then signed vendor contracts. In the past, they might have searched then said `let's wait a bit.' "

Some groups are turning I.T. up a notch because they foresee greater reliance on outcomes-based reimbursement and potential economic incentives from Medicare to communicate electronically. "A lot of groups are responding to the need to get better at demonstrating the quality of their services," says Margret Amatayakul, president of Margret\A Consulting, a Schaumburg, Ill.-based health care I.T. consulting firm. "They need data to support quality of service for pay-for-performance initiatives."

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