Salvatore Volpe, MD, (pictured, right) has 17 years of primary care practice experience. He sees 1500 – 2000 patients and is board certified in Pediatrics, Internal Medicine, Geriatrics and Quality Assurance. It’s almost impossible to believe that a solo practitioner this busy could sacrifice all the time, energy and funds necessary to implement his own Electronic Medical Records (EMR) system.
You may be surprised to find that it’s actually not as difficult as people may think, and the benefits far outweigh any initial inconveniences, according to Dr. Volpe.
In fact, once his office went electronic, the quality of life improved significantly for himself and his staff, he was able to cut costs appreciably, and patient satisfaction hit an all-time high, he said. And good news: he also said that selecting a system and implementing it wasn’t all that difficult either. In this article, Dr. Volpe gives his personal experiences with EMRs.
Quality of Life
“I structure work around my life now, not the other way around,” said Dr. Volpe, who gave examples of the newfound versatility he enjoys with EMRs, which were implemented in his office last April.
“If I want to sleep in tomorrow, I can, or if I want to go see my 15-year-old play in a marching band competition at the Meadowlands tonight, I will,” said the doctor. Instead of driving to the office for tasks like viewing lab reports, Dr. Volpe said that he can now access them anywhere – even from the comforts of his own home.
“After just six months of having EMRs in place, my office manager was able to work from home after having a baby,” said Dr. Volpe, who lectures on topics involving Health Information Technology, such as e-Prescribing and Electronic Health Records. “She was checking voicemail messages, taking calls, addressing things as they came in – all her regular job duties.”
Savings
Another major benefit Dr. Volpe has seen so far is the cost savings that came with implementing EMRs. “I used to have two full-time employees and two half-time,” said Dr. Volpe. “We are now operating with two half-time employees and two quarter-time – that comes out to an annual savings of $30,000.
“Plus, we were able to bump up revenue by 10 percent by increasing billing. This is done because I am now able to conduct better, more in-depth exams with complete history.”’
And for those concerned about the cost of EMRs, Dr. Volpe had this to say: “After doing the research, I found software for only $10,000. I know of other doctors who spent closer to $40,000. If you do the research and find the software that best fits your needs and your practice’s needs, you will avoid paying too much.”
Dr. Volpe explained that he served on the New York State Information Technology Task Force, and after reviewing over a dozen companies, they were able to narrow all the EMR-related software down to a short list of seven products – and that included something to accommodate everyone from a solo practice to a large group.
“I tell doctors who are considering EMRs to think of it this way: if your expenses drop by $30,000, that’s the same as making $60,000. How many patients would it take to make that much money? At $50 per visit, that would be 1200 patients. Now, you can spend that time with family… or if you’re so inclined, see those patients and make the extra money,” he said.
Patient Satisfaction
Half the time, patients walk out of an office and forget what the doctor just told them, explained Dr. Volpe. But thanks to EMRs, he said that problem is practically a thing of the past.
“Normally my notes are illegible, but now I am able to write in my convertible tablet, and the software processes what I write and turns it into text,” he said, adding that his SOAP notes (subjective, objective, assessment, plan) are easy for the patients to follow, and he is able to print them out, attach them to the diagnosis and give them to the patients.
Now, when a patient is referred to a specialist, they can bring these notes with them, he explained. “That way, the specialist has the benefit of seeing what I think is going on, and this eliminates their need to pull that info out of the patient. So the doctor can focus on the medical issues instead of acting as a scribe.”
It also helps with phone calls and customer service, said Dr. Volpe. When a patient calls the office to ask about the reason a certain test was recommended by Dr. Volpe, for example, he said that his staff can quickly access the notes and read the reason directly to the patient, eliminating the time it would normally take for the staff member to walk across the office, search for the files and locate the information (and try to decipher Dr. Volpe’s handwriting, he added).
Another example the doctor gave that demonstrates increased patient satisfaction was a situation involving a 21-year-old patient. He came in to see Dr. Volpe with a sore throat and enlarged tonsils. He had a throat culture done and was sent to the lab for blood work because Dr. Volpe said he was concerned about mono. A day later, the patient went to the Emergency Room with a 103-degree fever. Because he had Dr. Volpe’s notes with him from his visit, the ER staff was able to access his blood test results and deduce that he had mono. They administered him a shot of steroids and sent him home, said Dr. Volpe, avoiding the need to admit the patient and conduct their own tests.
Yet another major benefit of EMRs is its far-reaching database. “As doctors, we are trained to look for any potential adverse drug interactions. But with five million medications on the market today and five million permutations of those medications, it’s unlikely that we are going to catch every one.” Using EMRs, he said, reduces the likelihood that an adverse drug interaction could slip through the cracks.
And because EMRs can be accessed anywhere, at anytime, the versatility is seemingly infinite. “A patient of mine was in Florida and visited my counterpart, who was able to log into my files and access the patient’s records,” said Dr. Volpe. “It’s really, really cool.”
About Dr. Volpe
Dr. Salvatore Volpe, MD, FAAP, FACP, CHCQM, has served as a medical director or associate medical director for several national and regional Managed Care Organizations including Aetna/US Healthcare, GHI, Touchstone Health and United Healthcare. He is member of the Board of Directors of Medical Liability Mutual Insurance Company. Dr. Volpe has been interviewed by such diverse media sources as Crain’s NY Business, Medical Economics Magazine and Time Warner NY 1. He currently serves on the medical editorial board of Medical Economics Magazine and travels around the United States lecturing on topics involving Health Information Technology, such as e-Prescribing and Electronic Health Records.
Dr. Volpe is the recipient of the 2007 IPRO Quality Award. The award was presented in recognition of his commitment to improving care for Medicare beneficiaries, as reflected in the work he has done to create a patient-focused environment within his practice, and his work as a physician champion in promoting the use of electronic health records and health information technology for quality improvement.
Note: Read Dr. Volpe's Primer on EHRs here.