Dr. Nilesh Patel is a solo family physician at Millgrove Medical Center in Audubon, PA. Like many practices, his has faced many challenges on the road to achieving meaningful use. But through a combination of adaptiability and perseverance, his practice has found ways to overcome these challenges and improve patient care. `
Dr. Patel highlights three examples of how his practice has successfully navigated challenges.
Integrating Lab Results
Millgrove Medical encountered challenges incorporating outside lab results into the structured data of its EHR. An initial solution involved scanning results and saving them to a “Lab Results” folder. Besides being cumbersome, this solution did not fulfill the requirements from MU..
Millgrove brought its EHR vendor and laborator together to work on an integrated solution. “This was a step-by-step process and we can now incorporate the labs directly into the EHR and use the data in a meaningful way,” said Dr. Patel. “This was a time consuming effort since it involved outside vendors but one which has been worth the effort.”
Almost all primary care physicians struggle with medication resolution, and Dr. Patel is not exeption. Many patients routinely visit specialists, and leave those visits with altered medicaiton lists including additions, modifications, and deletions.
In this case, the answer was a change of procedure. According to Dr. Patel, “We are requesting changes and reconciling the medications at every visit. It is a time consuming effort but an important one, and with the help of our staff pharmacist, the process is being streamlined.”
While the goal of adding patient education resources to the EHR's structured data is a laudible one, in practice, patient education can be more challening. Dr. Patel shared that on many occasions patient education is an active process that goes well beyond proving a handout (e.g. demonstration of an inhaler to COPD patients, demonstration of an insulin delivery device to diabetic patients, demonstration of how to use pre-printed calorie count sheets, demonstration of home blood pressure monitors, etc.). Paper-based education has other limitations. “Often the patients are provided specific education resources in paper form to take home. The latter is particularly challenging since we have a large ethnic minority population and delivering the information effectively can be time consuming with the added barrier of limited language proficiency,” said Dr. Patel.
The practice takes a multi-pronged approach to address these issues. The practice does offer traditional printed educational informaiton electronically, but continues to use verbal deivery and in-person demonstraton, particularly in cases where language barriers may be present. Millgrove Medical also uses outside resources such as diabetic education classes to further bolster educaiton.
“The transition to EHR and Meaningful Use is an evolving process. There are many pieces to the puzzle and the process involves putting the pieces together,” said Dr. Patel. He emphasizes that patients are key collaborators in the MU effort, particularly for the many measures that relate to prevention and wellness. As he says, “Patient education is paramount.”
Dr. Patel recommends that practices seeking to achieve MU seek help from their regional extension center (REC). “Our accomplishments thus far can be attributed to the ongoing support and guidance from Peter Mercuri from PA REACH East. Their future support is going to be crucial if we are to continue on the road to successful Meaningful Use.”