the path to paperless
Our Network Begins to Pay Off
We are saving time and money in many areas.

In a multipart series, Dr. Polack is describing how a seven-partner practice, Ocala Eye in Ocala, Fla., with five locations and 140 employees, makes the major transition from paper medical records to EMR. During the course of the series, Dr. Polack will provide readers with a "real-time" look at how the implementation is progressing. This is part 16 of the series.

In a column that ran last year, I described some of the early benefits that I believed our practice was already gaining from our office network, even as we were still preparing for our full EMR implementation.

At that time, the idea that a computer network could make the practice more productive and would become indispensable was met with more than a little skepticism from many staff members — as well as from some of the doctors who were footing the bill.

Now, almost a year later, I went directly to the staff to see if they have taken advantage of the office network in their daily routines. Their feedback was encouraging. What I had already believed, and was able to confirm, was that the network is already paying dividends in numerous areas of the practice.

In this article, I'll describe how our significant investment of both effort and dollars is beginning to prove its worth.

Using the Network

Networked Devices. Expensive peripheral devices, such as color laser printers, can be shared among many employees, making them more cost effective.

E-mailing documents instead of printing. Any forms that have to be distributed throughout the practice are 'printed' as pdf files and e-mailed instead of printing memos and physically handing them out. This also allows the sender to keep a record of what has been sent out. I have also used this to scan and e-mail myself important documents which can then be shredded, so I don't have to drag paperwork home from the office.

'All hands' alerts. Previously, someone from medical records would have to call around to the satellite offices to try to locate a missing chart or document. Now this alert is sent to everyone in the practice via the network. This has significantly cut down on wasted time.

Security issues. Prior to setting up our practice-wide network, we had a rag-tag collection of PCs which were largely unsupervised. Any employee could send e-mail or access the Internet with impunity. Now that the amount of bandwidth we need for our EPM and EMR is critical, unauthorized use of this resource is a problem.

Our administrator can access e-mail or Internet usage by employees and be able to determine its appropriateness. It is important to note that employees should be instructed that any e-mail or use of practice computers is not considered personal and is subject to scrutiny.

Confidential documents. Our bookkeeper and business office personnel can send certain critical documents, such as financial statements, electronically with password-protection.

Public folders. Our executive secretary posts the doctors' social, meeting and on-call schedules. The clinical supervisor is responsible for posting announcements, memos and meeting minutes. The doctors have also posted articles of interest to others for viewing.

Our marketing director posts ad-tracking data as well as advertising proofs for review. Our EMR committee has a shared task-list folder for sharing progress on template changes or other projects.

Work order system. Our staff utilizes an on-line work order system for department-specific issues.

Examples could include such pressing issues as printer cartridges needed at a particular location, a leaky faucet in a satellite office, or a new employee starting next week who needs orientation, security codes and timecard access. These orders are then distributed to the appropriate department (physical plant, clinical supervisor, informational technology staff, human resources staff).

In the past, this process required phone calls or paper messages which would almost invariably get lost.

Batch scanning of paper documents. Temporary workers are being used to help handle the load of documents which need to be scanned into the EMR system. The batches are then processed by clinical techs, from whichever location they may be working at that day, and placed in the appropriate patient files.

Triage system. It has now been more than 2 years since we started using our Web-based triage program, and it has become an indispensable tool for documenting and tracking all patient-related phone calls.

All phone calls from patients are logged into the system by the operators. Two or three medical assistants are assigned to triage depending on the volume of calls. Because of the wide-area network, any other medical assistant in any office location can help out by logging in to the triage system and assessing the patient's problem. Very rarely is a phone call not returned, a prescription not refilled or a problem not resolved the same day.

Computerized HVAC control. The system tracks temperature and humidity throughout our ambulatory surgery center and plots these on a graph. Our nurse administrator can optimize the system depending on the use of the facility and can even remotely monitor the system from home if there is a problem at night or over the weekend.

We have been able to run the building much more efficiently and have already recouped half of the cost of the system in the first 5 months of this year from energy savings compared to last year.

Next: Alternatives to an EMR system

Peter J. Polack, M.D., F.A.C.S., is co-managing partner for Ocala Eye, PA, and a specialist in cornea, external disease and refractive surgery. Founded in 1971, Ocala Eye is a seven-partner, multisubspecialty ophthalmology practice located in Ocala, Fla. The practice, which has five locations including an ASC and laser center, has 140 employees. He can be reached by e-mail at ppolack@ocalaeye.com.