Juan Salazar, M.D., a solo internal medicine practitioner in McAllen, Texas, recently received one of the first Medicare electronic health records meaningful incentive checks (for $18,000). He's been practicing for three decades and only adopted an EHR about 18 months ago.

Salazar understands the fears of peers to switch to electronic records, believing them to be cumbersome and adding little value to their practice. "When I started with EHRs I had the same fears," he notes. "I was changing cultures."

But he'll never return to paper because the ambulatory EHR from Cerner Corp. has made him and the office far more efficient while improving care. Patients, for instance, can see their health status trends on the laptop "and it gives a sense of wellbeing that they're getting better."

Salazar sees the same number of patients and goes home at the same time that he did in a paper environment, but now his charts are done before he leaves.  The time he spends on entering data is more than offset by the time saved as he isn't asking patients the same basic health history and status questions each visit because that information already is on his screen. His message to peers: "I'd never worked on an EHR in my life and if I can do it, anyone can."

As Salazar and the staff learned how to use the EHR, they found out how inefficient they were without it, says Janie Davila, office manager.

Achieving meaningful use actually was quite easy, she adds. The toughest part was learning how to access all the data in the system, which includes scanned historical information as patients are seen for the first time since the EHR went in. But all the information they needed to attest to meaningful use was in the system and accessible, Davila notes. "The end-of-month reports are right there and I can graph anything I want."

She cautions other providers, however, to be prepared for some push-back from patients who may feel offended when asked for certain demographic information, particularly race and ethnicity. But they accept an explanation that information is a new requirement.

Salazar will use some of the first-year meaningful use incentive check to pay bonuses to staff, and save the rest.

--Joseph Goedert

 

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