Dr. Saver Discusses How Meaningful Use is a Team Sport
Dr. Saver is one of twelve physicians at Primary Care of the Treasure Coast , a primary care practice with a large geriatric population that specializes in family and internal medicine in Vero Beach, Florida. Dr. Saver and his practice began using an EHR about seven years ago. Within three months of EHR implementation, all physicians in the practice were using only the EHR.
Super Users Help the Practice Achieve Meaningful Use Stage 1
Dr. Saver’s practice employs about 70 clinical staff members. In order to facilitate EHR training, the practice identified super users, who are clinicians that adapt quickly to an EHR and are well equipped to train their colleagues. Peer training was a critical factor that allowed the practice to achieve meaningful use stage 1. The practice also leveraged super users to train new hires and retrain employees after system upgrades. As Dr. Saver says, “Training is critical for achieving meaningful use stage 1 and it also remains critical after attesting to meaningful use.” He advises practices that either plan to implement an EHR or already have one to build a long term training plan.
Practice Challenges: Engaging a Geriatric Patient Population
Once familiar with the EHR system, Dr. Saver worked to seamlessly integrate it into his workflow. Dr. Saver has found that an EHR helps increase practice efficiency. Physicians can log into the physician portal and access patient records instantaneously from any location, freeing up time previously spent searching for and pulling patient charts. But, the geriatric population of his practice posed unique challenges to patient engagement. In particular, challenges emerged in the areas of portal use and medication management.
- Driving patients to the portal. While the physician portal has been a helpful tool for the practice’s providers, the practice has found it challenging to get patients to use the parallel patient portal. The lack of use can be attributed to Dr. Saver’s geriatric patients that have limited experience with technology and are not comfortable learning to use a web-based patient portal.
- Maintaining a medication list. Dr. Saver uses the EHR as a tool to maintain medication lists for his patients. Medication lists are especially important for Dr. Saver because many of his patients take multiple medications that may be prescribed by physicians outside of the practice. To facilitate list development, office staff members, upon calling patients to confirm their appointment, request patients bring all of their medications with them to their visit. Despite this, only about 20% of patients did so, resulting in incomplete entries in the EHR.
Leveraging Staff to Engage Patients with Technology
Dr. Saver’s practice had to develop creative ways to engage patients and communicate how an EHR can help improve care delivery. In order to drive patients to the portal, the practice implemented a portal registration system during the checkout process. Staff members educate patients about the portal, explaining that it is free and will provide secure access to the patient’s own clinical information, billing and payment information, and secure email, and then they offer to enroll patients on the spot. Interested patients walk out of the office with a username, password, and login instructions. The hands-on process has helped bring some traffic to the portal, but Dr. Saver recognizes the practice will need to continue to develop innovative enrollment strategies as it looks towards meaningful use stage 2, which requires that more than 50% of patients [PDF - 205 KB] are provided online access to their health information.
Practice staff also work together to develop more successful communications to the patients. Instead of asking patients to “please bring all your medications to your appointment,” when staff members call to confirm appointments, they now say “put all your prescription and over-the-counter medicines into a bag now, and bring this bag to your appointment.” With this change in wording, the percent of patients who bring their medications with them to the office has increased from 20% to 80%. When patients bring in their medications, providers can maintain more accurate medication lists in the EHR. With more complete information in the EHR, Dr. Saver can use the EHR for care coordination and more efficient electronic refills and ultimately provide better health care to his patients
Meaningful Use is a Team Sport
The field of health IT is continuously evolving. Adapting to change and relaying change to patients is a team effort. As Dr. Saver says, “The support of everyone in the practice is critical to navigating the changing health care landscape. Everyone played a part – from training to patient engagement – in helping the practice attest to meaningful use stage 1 and everyone works together to continue promoting meaningful use of the EHR.”