This is the second in a series of blog posts where we ask the question “What is a Meaningful Use of an EHR?

In this post we spoke with Dr. Frank Maselli, a family physician at the Riverdale Family Practice in the Bronx, about his experience using electronic health records, specifically:

• whether he thought it prevented medical errors in his practice, and
• whether he thought it helped him more quickly diagnose patients – particularly related to improving early cancer diagnoses.

As Dr. Maselli explained in our previous post, the Riverdale Family Practice’s use of EHRs has allowed the practice the ability to more efficiently store and use medical records, and therefore is having a profound impact on Dr. Maselli’s ability to care for his patients.

Preventing Medical Errors Through e-Prescribing

The use of health IT as a tool to build the practices capabilities to coordinate care is the real legacy of the adoption of health IT.  Dr. Maselli can’t say enough about the e-prescribing component of his EHR:

“There’s so little error when you do it (send prescriptions) electronically. Before we went to an EMR, the pharmacies would call us constantly. It’s the wrong dosage, or the insurance doesn’t cover this. On and on … with our current system, if it’s green it’s good,” he says. Yellow – partial coverage. Red – no coverage. “It’s green a lot.”

EHRs Aiding in Early Cancer Diagnosis

Dr. Maselli has been paying particular attention to the number of cancer patients that his EHR has helped diagnose across the practice. According to his accounting, the system has helped the doctors identify three cases of asymptomatic breast cancers and one case of colon cancer. This means that four people are healthier now because Dr. Maselli used an EHR that helped him diagnose and treat deadly cancers earlier.

“I can’t say how many polyps we caught. And how many cancers we prevented later on in life… Quite a few is probably a safe guess.”

The Riverdale Family Practice EHR has reminders that have aided early cancer diagnosis

Dr. Maselli admits that the EHR they use has a large number of automatic reminders. Some examples are:

• Ask the patient about guns.
• Remind the patient to put batteries in his smoke alarm.
• Some are even out of date (warnings when prescribing beta blockers to heart patients, he volunteers).
• Remember to give certain patients mammograms.

It was the last reminder that has driven his staff to get those mammograms done and is helping the staff diagnose cancer earlier.

“It (the EHR) works because you can still do your job as a doctor. The main thing is that I need to take care of the problem that the patient presents with. I need to focus on that first.  It’s equally important to take care of all these side issues,” he says.

The Riverdale Family Practice’s effective “meaningful use” of EHRs is also being recognized in the community. Brent Stackhouse, the executive director of the New York City Regional Extension Center at the Primary Care Information Project is proud of the partnership:

“The team at Riverdale Family Practice has been visionary in the Bronx and crucial to the success of NYC REACH. Having been a pilot site for our quality improvement, billing optimization, and patient engagement programs, Riverdale will continue to be a key partner in the expansion of our PCMH, ACO, and ICD-10 services.”

What does Maselli think the future holds for Meaningful Use of EHRs?

Ultimately, the system is performing the way Dr. Maselli expects it to and “I am able to spend more quality time with my patients.” Dr. Maselli says he is worried, however, about interoperability across the system in which he practices and he still sees a high number of nursing homes without any health IT system whatsoever, but it’s changing and he is optimistic about the future.

“In the long run, we made back the money we spent through efficiencies.”

So Let’s Get Back to the Question: What is Meaningful Use of EHRs?

Dr. Maselli is a great example of the meaningful use of EHRs. He is using an EHR to:

• reduce hospital readmission,
• is preventing medical errors, and
• is even aiding in early diagnosis of cancer

We would love to hear from you in the comments below. Please share with us your example of meaningful use of EHRs.

Have you seen prevention of medical errors or has it assisted you a medical diagnosis? Please leave your comments below.