Small practices can do big things with EHRs

Among the winners of HIMSS' 2006 Davies Awards are two primary-care practices that have gone the extra mile in health IT, Alpenglow Medical of Fort Collins, CO, and Piedmont Physicians Group of Atlanta.

A three-doctor internal-medicine practice, Alpenglow acquired its Praxis EHR when it opened in 1999. Since then, the practice has used the low-cost system to help create an unusually patient-friendly workflow and to improve quality to the point where representatives of the state QIO paid them a visit to find out how they did it. Prompted by the fact that Alpenglow was in the top one percent of the state's practices on measures like HbA1c levels and mammograms, "they identified us and came out to analyze our workflow as part of the Doctors Office Quality-IT project," says Daniel Griffin, one of the group's founders.

The analysis found that "our average wait time is about a minute. Ninety-one percent of a patient's time in the office is spent seeing a physician. Now the QIO is working with other practices to achieve this workflow performance," says Griffin. He adds that while the EHR has definitely helped in some areas, such as automating lab results, much of the practice's success has been based on enhanced customer service.

Office reengineering was also essential to Piedmont's implementation of a GE Centricity EHR in 1999. A hospital-affiliated group of eight internists and two PA's, Piedmont hired an industrial management firm to do a workflow analysis before it acquired the EHR, and it has continued to use the firm to see how its operations have changed at one, two and five-year intervals. The results: productivity has increased by 115 percent, and costs have dropped sharply due to reduced labor and transcription costs. According to group spokesman and rheumatologist William McClatchey, Piedmont has more than recovered its investment in the EHR system and the outside consulting services.

Could an independent practice do this? Yes, says McClatchey, but he doubts a small office could, because of its lack of resources. "Until the small mom and pop practices roll up and develop larger organizations, we're not going to be successful as an industry," he declares. While that obviously doesn't apply to Alpenglow, not every practice has a tech-savvy leader like Daniel Griffin.