Strong commitment and solid prep work put PHMG on the fast track to EHRs

The management team at Primary Health Medical Group (PHMG), a multi-specialty medical group with 13 clinics in Idaho’s Treasure Valley, decided to make the transition to electronic health records (EHRs) a priority for 2007. Before the year was out, they had identified a core team, chosen a vendor, trained staff, and successfully launched the EHR system in all 13 clinics.

"The ‘go-live’ period at each clinic was much less problematic than typical; there was only a small dip in productivity," Helen Stroebel, Qualis Health’s quality improvement director for the Doctor’s Office Quality – Information Technology (DOQ-IT) project in Idaho, stated. "PHMG did a great job preparing."

Dr. James Weiss, a physician at PHMG’s Meridian clinic, agrees that advance preparation helped everything go more smoothly. In his own case, he found it very useful to take a proactive stance. He says that he "started playing with the software, clicking all the buttons, looking at all the screens, and practicing charting hypothetical patients" well in advance of the Meridian clinic’s go-live date. He also pre-loaded all of his thickest charts into the system, which made the initial transition much easier.

Weiss credits the project’s physician champion (Dr. Lisa Dockter, at the Meridian Crossroads clinic) and PHMG’s IT staff for pulling everything together so smoothly. "They did their homework to do this the right way," he said. Implementation planning included revising some workflows and training several "super users" throughout the PHMG system. Weiss reports that Dockter "used a good approach to get at [providers’] psychological barriers to change—it definitely was not a one-size-fits-all solution to helping them make the transition."

While many physicians across the country have decided not to switch to an EHR until absolutely forced to do so, Weiss believes that EHR usage is really the right thing to do. He recommends that providers "approach it with a teachable spirit" in order to best prepare for the transition, as well as to get the most return from an EHR. He’s already seen big improvements in terms of saving time, especially regarding prescription writing and refills. In addition, the EHR system allows him to check his schedule from home and prepare for the day’s patients. The easy access to records also greatly simplifies being on call.

He has found that being able to review the patient’s entire chart provides opportunities to collaborate and optimize care. "Now I can see what happened when a patient visits the dermatologist or the ER and adjust my approach accordingly," Weiss said. The EHR system also allows him to see what others do with a certain diagnosis, which he believes can help support evidence-based practice. He asks himself "What does the specialist do, or my other colleagues? Is it different from my usual? What can I learn from them?"

Finally, Weiss notes that while patient reviews have been mixed, most think the transition to EHRs was overdue—and that the clinic has now "come up to speed with the rest of modern America."

Next steps for PHMG include rolling out a web portal, which will allow patients to look at their own records and request appointments via the Internet. They are also participating in a pilot project with Blue Cross Idaho regarding reimbursement. (The data needs of this project are greatly facilitated by the EHR.)