How to Extract Value from an Ambulatory EHR

James Holly, M.D., is a believer when it comes to EHR technology … his practice, Southeast Texas Medical Associates, has invested $6.5 million in I.T. over the years …


James Holly, M.D., is a believer when it comes to EHR technology for physician group practices. His practice, Southeast Texas Medical Associates, has used digital documentation since 1999—and has invested $6.5 million in I.T. over the years, “all private funds,” Holly told the audience at his HIMSS presentation. But Holly says that unless physician groups use the technology to document—and improve—quality, the EHR is not worth the cost.

The group practice has jumped into quality measurement full force. It tracks some 250 quality measures, including several standard industry measures such as HEDIS and PQRI. The practice has layered a business intelligence tool atop its NextGen ambulatory electronic record system. It can track multiple metrics for any patient with a given condition.

Holly says that is the best approach when addressing patients with such conditions as diabetes. The group for example can track nine metrics for its diabetic patients, including eye exams, blood pressure, flu shots, blood sugar test scores and levels, and foot exams.

Its business intelligence system generates reports which show how well the practice is treating patients with chronic conditions. That enables the physicians to analyze what to do to help keep the conditions under control.

One metric revealed that patients maintaining positive diabetic profiles had on average five office visits annually. The group falling short had less than four annual visits, a metric suggesting these other patients may need to come in more often, Holly said.

The group publishes it own quality scorecards on its Web site, Setma.com. It also publishes patient satisfaction scores with the practice. “We are giving our patients a degree of confidence in us by doing that,” Holly said. “Today the cost of health care is astronomical and the trust is almost non-existent. Physicians don’t need new streams of revenue, they need new streams of trust with patients.”

--Gary Baldwin