[10/31: I'm giving a free webinar on Wednesday, Nov 5th! It's about the same EHR workflow tech that won the HIMSS Davies Award three times in a row! See you there! Give me a shout out on Twitter just before! Cheers! --Chuck]
— Charles Webster MD (@wareFLO) October 29, 2014
The first two physicians in solo practice who won the most prestigious award for use of an EMR are pediatricians. They won the HIMSS Davies Award in 2003 and 2004. They do not use a traditional pediatric EMR. Instead, they rely on a pediatric EMR workflow system (based on an EHR workflow management system). A third physician who specializes in family practice, obstetrics & gynecology in solo practice has also won the Davies Award (2005) for his use of an EMR workflow system that combines family practice, obstetrics & gynecology workflows. (While I’ll focus on the pediatric EMR workflow management system functionality here, I will also refer to the family practice, obstetrics & gynecology EMR workflow system as it relates to shared primary care concerns. I’ll focus a future post on the 2005 HIMSS Davies award application.)
Dr. Jeffrey Cooper, MD, FAAP, has used an EMR Workflow System at Cooper Pediatrics in Duluth, Georgia, since 1995. Dr. Armand Gonzalzles, MD, FAAP has used an EMR Workflow System at RiverPoint Pediatrics in Chicago, Illinois, since 1999. Dr. Cooper and Dr. Gonzalzles won the HIMSS Davies Award in 2003 and 2004 respectively.
Dr. Cooper and Dr. Gonzalzles both provide the following pediatric services: well child care; immunizations; hearing and vision screenings; sick visits, minor injury management; nebulized aerosol treatment; and school, preschool, disability, and family leave forms.
Dr. Cooper Pre/Post Results Summary
Dr. Cooper increased billings 400% and revenue 271%, which resulted in an increase in practice profit of 100%. Average charges per visit increased 171%. Before implementing a pediatric EMR workflow system Dr. Cooper saw six patients an hour. After implementing the pediatric EMR workflow system Dr. Cooper saw eight to ten patients an hour, even during the busy flu season. Previous to implementation Dr. Cooper’s practice had been closed to new patients. Several years after implementing the pediatric EMR workflow system Cooper Pediatrics total active patient count had more than doubled. Charting time decreased from four minutes to less than one minute (including prescription writing). Total patient check-in to check-out time decreased 42%. Both telephone call and drug refill turnaround time decreased 75%. Quality review scores increased from 90% to 97%. Immunization rate increased from 90% to 99%.
You can find Dr. Cooper’s original HIMSS Davies Award application here.
Dr. Gonzalzles Pre/Post Result Summary
Revenue increased 77.5%. Profit increased 90.8%. Charges per visit increased almost 50%. Patient volume increased 200%. Immunization rates increased from 50% to 95%. Using link from pediatric EMR workflow system to already in place practice management system: collections increased from 52% to 88%, denied claims went from 30% to zero, and insurance turnaround time decreased from 30 to 60 days to an average of 15 days. Charting time decreased by 72%. Telephone and drug refill turnaround times went from 24-28 hours to 15 minutes (or less). Quality review scores increased from 65% to 95%.
Dr. Gonzalzles’ original HIMSS Davies Award application can be found here.
In each winning HIMSS Davies Award application the physician author specifically mentions the importance of the EHR workflow management system foundation that makes their pediatric EMR workflow system possible.
…workflow management system. This allows me to customize and streamline collaboration among providers and staff in ways that greatly improve practice efficiency. For example, while I am in the exam room with the patient, in addition to documenting, I am also directing and delegating. Staff members can prepare for procedures such as vaccines, aerosols, and injections before I even leave the room. We usually pass each other, me on the way out, they on the way in. I go immediately to the next patient, while they immediately perform their procedures. I don’t have to find them and I don’t have to tell them what to do. The EMR’s workflow management system takes care of that for me. (Dr. Jeffrey Cooper, MD, FAAP, Pediatrician)
The main advantage to EMR users of getting both a workflow system and a workflow management system—together—is that they can further customize the EMR workflow system to reflect their clinical needs, personal preferences, and business requirements. (Dr. Armand Gonzalzles, MD, FAAP, Pediatrician)
It is worth considering along side the above quotes the following quote from Dr. Harris’s 2005 winning HIMSS Davies Award application:
The EMR user interface is akin to the touch screen-oriented systems in restaurants: one screen at a time, with only the most relevant data displayed and options presented (although, of course, a user can always jump out of a particular screen sequence to accomplish an arbitrary task), and the sequences can be tweaked through the workflow management to make such occurrences infrequent…The workflow plans are tailored for each type of patient seen in the office (obstetrics, gynecologic, annual exams, family practice) assuring that key elements of the present illness, history and physical are addressed and documented. Work plans contain required laboratory tests for specific conditions, assuring that key tests are not forgotten. (Dr. Jeffrey Harris, MD, Family Practice, Obstetrics & Gynecology)
Dr. Harris’ original HIMSS Davies Award application can be found here.
All three HIMSS Davies Award applications speak eloquently for themselves, about dramatically increased “good” statistics (patient volume, active patients, revenue, profit, quality scores, and immunization rates) and just as dramatically decreased “bad” statistics (time to chart, wait time, check-in to check-out time, denied claims). All three winning applications explicitly attribute the success of their respective pediatric EMR and family practice, obstetrics & gynecology EMR workflow systems to the unique EHR workflow management system that serves as their foundation.