Allscripts Enterprise EHR™

CVA becomes paperless fast using scanning services from DISC. CardioVascular Associates (CVA) was founded in 1946 by Dr. John Burrett, the first cardiologist in Alabama. Centered in Birmingham, CVA has grown to 29 cardiologists who provide care at six area locations. With physicians who specialize in an array of diagnosis and treatment options, CVA has created a network of talent, skill and technology where patients aren’t just cared for - they are cared about.
 

Opportunities

ELECTRONICALLY ACCESSING HISTORICAL RECORDS

Patients’ historical records are the heart of CVA’s practice, with some of its physicians seeing the same patients regularly for 20+ years. In 2004, CVA stood before the proverbial fork in the road. To keep practicing medicine as it had been would require additional storage space for records, the replacement of a costly chart rack system that was nearing the end of its lifecycle, and continued struggles with managing thousands of patient records – containing millions of images – across multiple sites. CVA chose the path that would lead the practice into a paperless environment and higher efficiency.

Solutions

THE POWER TO HANDLE BUSY PRACTICES

Allscripts Enterprise EHR is the first truly “transformative” Electronic Health Record. It defines the third-generation of EHRs with its major advances that include:

• Sub-second response times
• Redesigned user interface that reduces some clinical workflow clicks by 40%
• Ability to broaden the product into clinical trials, in-office medication dispensing, personal health records, and pay for performance

CardioVascular Associates eventually decided to install Enterprise EHR, but not until experiencing some detours resulting from early conversion efforts that didn’t meet their expectations. CVA’s initial plan was to have its staff handle the scanning of historical records for use in the EHR. The scanned images would be uploaded into Allscripts Document Management which CVA had used for 2 years.

CVA quickly discovered that performing the conversion in house would require them to hire and train additional staff to meet deadlines, which would increase operational costs. In addition, CVA learned that there was a greater need to provide physicians with all the functionality they demanded.

To search for a new solution, CVA representatives attended the 2006 Allscripts Client Experience (ACE). “At ACE 2006, we saw a demonstration of the new Enterprise version 11. The look and flow of this system upgrade was what our physicians were wanting,” said Mike McKinney, MD, FACC, Cardiologist leading the EHR project at CVA. “We’ve had good experiences with Allscripts Document Management and Allscripts in the past, so we decided to once again evaluate their solutions. Plus, Allscripts is a well-respected company in the EHR market.”

OUTSOURCED FILE CONVERSION SAVES TIME

To expedite the scanning of historical records, CVA turned to Document Imaging Systems Corp (DISC), based in St. Louis, which provides document management, mass conversion, and consulting services. CVA was introduced to DISC by Allscripts after requesting information on professional conversion services.

“For an EHR to work at CVA, it needed to contain the historical records that our physicians rely upon for treatment decisions,” said Susan Carson, EHR Project Director at CVA. “Unlike other types of practices, we simply couldn’t pick a date and go paperless from that point forward. If we did that, our physicians would end up relying on paper charts for historical information while simultaneously working with the EHR, negating many of the EHR’s benefits.”

DISC converted about 15,000 charts that contained 2.7 million images. DISC started by doing a mass conversion at CVA’s Brookwood Medical Center location. Once all of those records were converted, DISC performed a schedule-based conversion at CVA’s Trinity Medical Center site. The schedule-based conversion took place over a 12-month period by scanning the charts in advance that were needed for the next month’s scheduled appointments. Other CVA locations used a combination of mass conversion and schedule-based conversion.

Outcomes

OUTSOURCED SCANNING PROVES EFFECTIVE

“We currently have one-third the staff that we did when we were scanning our charts,” Carson said. “We’ve been able to do a lot with the space that was previously used to store files. The former file room at our Brookwood location has been converted to allow for more exam rooms, resulting in increased revenue. At our Trinity location, the former file room has been converted to allow some departments to relocate, which will decrease space-rental costs by $60,000 per year. In addition, our newest location, Shelby, was opened without a file room!”

During conversion, charts were indexed based upon their corresponding components – lab, notes, X-rays, correspondence, etc. – enabling easy retrieval of key data upon system go live. DISC delivered the digital images to CVA via DVD. The reduction in the storage space needed for files has had a dramatic impact on CVA.

“DISC was easy to work with and when we needed a file that they were in the process of converting, they would fax it to our clinic right away,” said Julie McCutcheon, Health Information Management manager at CVA. “DISC provided a secure, quick turnaround on getting charts scanned and helped us save on staff costs and equipment.”

TRANSCRIPTION COSTS ARE DECREASING

The Enterprise EHR went live at CardioVascular Associates in January 2007. Almost immediately, CVA realized a significant reduction in its transcription costs, saving almost $33,000 during April, May and June. “We are beginning to see a decrease in transcription costs as we continue to move forward with Enterprise Note, seeing an 8 percent reduction in April, a 13 percent reduction in May and a 50 percent reduction in June.”

MOVING FORWARD

CVA is currently working on the implementation of Enterprise StudyManager and Enterprise Analytics. “Allscripts Enterprise EHR provides our cardiologists with the information they need for treatment decisions, while providing our back-office staff with the information they need to run the business and control costs,” Carson said.

Practice Administrator, William Cockrell, FACMPE, states “Had we hired staff to scan those charts, the costs involved would have been significant and implementation delayed. Using a specialized company like DISC, allowed us to get individual physicians up and running much more quickly than if we had scanned the charts ourselves. This allowed us to enhance patient care through information accessibility, enabling us to experience financial savings more quickly. Our 2007 transcription savings will offset our conversion costs.”