Physician series: EHR vendor went bankrupt right after paying
As far as EHR adoption horror stories go, Dr. Andrew Bronstein, an orthopedic surgeon at The Bronstein Hand Center in Las Vegas, NV, has a whopper. Days after paying his first EHR vendor a significant sum to implement a system for his office, the company filed for bankruptcy protection, leaving Bronstein in the lurch. Forced to explore other solutions, Bronstein turned to the cloud. He sat down with EHRintelligence to discuss his experiences and give his advice to other physicians interested in EHR replacements.
What was it about your first EHR that made you switch?
Every physician faces a daunting task to find the “correct” EHR that fits their personal practice style. Some physicians are tech savvy while others are technically challenged regardless of their talents as a physician. Furthermore, every physician specialty has its own nuances and requirements for documentation not only professionally to discuss relevant information amongst peers, but also in a manner that will be reimbursable by insurance companies and third party payers. Finally, the pace and style of patient interaction is of extreme importance as the EHR needs to be a complimentary tool to deliver quality healthcare, not a barrier that has been inserted between the doctors and their patients.
When I first found the ideal, server-based, multiple-award-winning software to meet my practice needs, I purchased all the hardware and software to implement the transition, and on the second day of a scheduled two week install the EHR vendor no-showed, and apparently plunged into bankruptcy.
I was left with a lot of expensive “paper weights” on my desks, as the computers had locked Windows passwords and software, and no way to utilize the hardware or software and no recourse due to their bankruptcy.
Why did you choose a cloud-based solution?
Subsequently, I chose a cloud-based solution as I felt it would be more nimble. I was jaded by the prior experience of reliance on an in-house server that not only was prone to a company’s well-being, but more importantly that the data could be in essence not retrievable or become obsolete. The non-cloud systems are only as good as the software version last installed.
The common denominator in these systems is licensing, which vendors often will dangle annually in front of end-users, which requires the physicians to constantly update to stay relevant. Given the rapid changes in healthcare, it is too challenging to do that monthly, if not weekly. On a cloud-based EHR, all relevant changes are made in the background, during off hours, so every day the physician is using the newest, latest version.
Does Practice Fusion work intuitively for your office? Does it cater to the needs of your specialty?
Given that it is “free” to the physician, there is no downside to trying Practice Fusion’s software. I personally tried it out in the privacy of my home on a Sunday, and was up and running the following Monday in my office. All other EHRs I explored were not as intuitive, or customizable, and required hours with representatives for sales pitches, training, and module updating. With Practice Fusion, I was able to make my templates for documentation diagnosis-based, so that typical answers to typical queries were at my fingertips and only a mouse click away for entry. I was spending $1000 per month on transcription (let alone charts), and over one weekend this cost went away with well-designed and thought out templates customized to the pace and style of my practice.
Do you have a plan for ICD-10? Where are you in your preparations?
ICD-10 is the classic example of a moving finishing line during a marathon race. I have been in practice since 1995, and ICD-10′s deadline has changed more times than I can count. In essence, with the rules constantly changing, I have chosen to rely on my software companies to stay relevant and help meet the deadlines.
In my specialty alone, one code now will have 10 -20 additional sub-codes. Back in the world of paper charts and insurance claims, it would be an insurmountable transition. Now with computer software, translators, nimble EHR and billing companies, I believe the transition will be manageable for the ability to search a diagnoses and get a narrowed list of options to assign the correct code.
Once again, this will require physicians to be more concerned about remaining tech savvy than worrying about becoming clerical numerologists. Physicians through their desktops, laptops, tablets and smart phones should have at their fingertips the ability to gain access to medical codes as the rest of the population has the ability to searches in their relative interests.
What advice do you have for other physicians who are interested in switching EHRs?
The first step is to honestly have an introspective look at one’s practice, understanding the information needed for quality and reimbursable documentation and the pace they have been accustomed at which to work. Second is intelligently designing their templates to fit their practice flow so that they can have a synergistic rather than antagonistic interaction with their software. Thirdly, their EHR should be available on demand to them at all times regardless of setting (which is a cloud advantage). Finally, the price should be important so that they can sleep at night knowing they got great value for this most important investment in their practice beyond their own education. SOurce
