Deciphering what a doctor scrawled on a small slip of paper is a problem of the past for Community Memorial Health System’s two hospitals in Ventura, CA.
On Jan. 1, Community Memorial Hospital and Ojai Valley Community Hospital—with a combined 615 doctors, 300 of whom are active on the medical staff—overhauled its electronic health record system to use PatientKeeper Inc. The mobile platform allows doctors to record notes, analyze charts, review vital signs and order medication via a mobile web site or an app.
PatientKeeper is currently used in about 450 hospitals and practices by 60,000 physicians, says PatientKeeper co-founder Sally Buta. Doctors can access PatientKeeper through an Internet browser or via an app for both iOS and Android smartphones and tablets.
Under the Health Information Technology for Economic and Clinical Health Act of 2009, a hospital that had not implemented full electronic health records by Jan. 1, 2015, would be penalized 1% of its Medicare reimbursements. The following year, the hospital would lose 2% and so on until the hospital changed its system. It was that law that drove Community Memorial to upgrade its electronic platform, says Dr. Stanley Frochtzwajg, chief medical officer at Community Memorial Health System. Community Memorial faced a loss of $1 million in this year’s Medicaid reimbursement if it didn’t switch.
The two hospitals had an electronic health record system, but believed the PatientKeeper platform is more user friendly. That user friendliness, in turn, would encourage more personnel to use the system and help put Community Memorial in compliance with the law. The issues with most electronic health records, Buta says, is that they were designed to help run a hospital, and not for a physician’s workflow, so a patient’s information isn’t centralized, the system is cumbersome to navigate and it is designed for desktops.
Besides financials, the driver for Community Memorial Health System to implement a full digital platform was problems with legibility of doctors’ notes, Frochtzwajg says. Besides other doctors needing to read notes about patients, handwriting was a struggle for nurses, pharmacists and patients, he says. Also, the system formats the notes into a more logical sequence, Frochtzwajg says, as doctors take notes in different ways, and if they are in a hurry, they often skip items in the narrative. The full notes are important, Frochtzwajg says, for billing government and third party payers. Also, since the records are electronic, they can be easily shared with a family doctor, specialist or others.
Community Memorial rolled out the platform on a voluntary basis to its staff in the summer of 2013.
By Dec. 31, one-third of the staff was using PatientKeeper all the time, Frochtzwajg estimates. On Jan. 1 of this year, like it or not, the entire hospital staff went fully digital.
“It was implemented over 18 months and allowed people to come on board with greater familiarity and ease,” Frochtzwajg says.
The system takes about an hour to learn Frochtzwajg says, and even faster for younger doctors who may have used similar systems in their residencies. Some doctors have resisted giving up their old ways, Frochtzwajg says, and the electronic system will take longer for them to learn.
Doctors mostly use their personal mobile devices to use PatientKeeper and often switch between phone, tablet, laptop and desktop throughout day. Many doctors prefer to use a laptop and access PatientKeeper through the web, because note taking is easier with a keyboard, Frochtzwajg says.
The goal is for doctors to become more efficient when seeing patients, spend less time writing and ultimately see more patients. Since implementing the system, notes are more accurate since there are no handwriting discrepancies, he says.
Knowing that doctors are not sitting at computers, PatientKeeper is meant for doctors to use throughout the day while meeting with patients. Through the platform, doctors know which patients are in that day and where they are within the building. When they meet with the patient, they can pull up that patient’s records that the nurse has already gathered. The note taking system prompts doctors to record medical history, physical exam findings, and other pertinent information. After a meeting, physicians can immediately record and itemize what they did for patients, as well as order medication. If a patient frequently comes in, the doctor can see previously ordered medications and reorder the same ones. Physicians can select favorite medications customized for them so they can easily place routine orders. Lab results, which are entered into the hospital’s electronic health record system, are integrated into the PatientKeeper platform so doctors can analyze them and order medication based on the results. Nurses can also enter updates, diet restrictions, and other requirements in the record system and the information syncs to PatientKeeper so every user sees the updates.
Checking on patients anytime from anywhere, also has its appeal, Frochtzwajg says. Doctors can check on patients’ charts and records while they are eating breakfast at home or eating lunch in the cafeteria, or analyze X-rays that come in late at night..
Patients using PatientKeeper, meanwhile, benefit from having to fill out redundant forms and repeat information about their medical history and medications since it is all in the app.
PatientKeeper is behind a firewall and password protected. If data is sent outside of the practice’s firewall, it is encrypted
Buta says recording patient services immediately on PatientKeeper helps with lost charges, which happens when doctors aren’t billing for all of the services they perform. For example, when administering a flu shot, the doctor should bill for the drug, the work to inject it and the administration with processing the patient. Many times, hospitals and doctors miss charging for some of those steps, Buta says. Typically, after PatientKeeper is implemented, hospitals or offices will see a 4-10% increase in revenue because billing is more accurate, she says.
The charges Community Memorial Health Systems sends in are more solid and defensible because of the improved documentation, Frochtzwajg says. The hospitals revenue has gone up, but they have not attributed how much is related to PatientKeeper.
The system’s cost varies on how big the rollout is and how many applications the hospital wants. For small practices of 20-25 physicians, the PatientKeeper platform could cost less than $100,000, which would include a three-year contract. For large projects when a hospital decides to roll out the entire system, it could be more than $1 million, Buta says.
Community Memorial Health System also considered systems from Epic System Corp., Cerner Corp. and Medical Information Technology Inc. Community Memorial chose PatientKeeper because it runs as an add-on, or in conjunction with its current system, making it more cost effective for the health system.
Follow mobile business journalist April Dahlquist, associate editor, mobile, at Mobile Strategies 360, @Mobile360April
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