Customer Successes
A traveling paperless office - A case study on EMR and Practice Management.
Overview
Dr. Louise Feddema is a family physician based in
Challenges
Dr. Feddema's ambition is to be the first physician in
Traveling hundreds of kilometers across remote areas can be a major problem by itself. When you add in the necessity to carry around hundreds of patient files and charts, the challenges can become formidable. Working in areas with poor or no wireless capabilities was a hurdle that had to be overcome before any paperless system could be a reality. "I knew I needed expert support and backing to get my practice running. Once I was in the field working I couldn't take a chance that I wouldn't be supported."
Nightingale’s Solution
The first decision was to go paperless. The next was to find the right system. "I was looking for a system that gave me the support I needed, Nightingale gave me everything I was looking for and more. They understood the needs of a medical practice management. They were there with suggestions that made my practice management more efficient and easier to run."
"When you're in the bush with a laptop and no way to get on line you start to think that maybe paper is the only solution. That is not the case with my system."
When she is cut off from on line access, Nightingale On Demand Electronic Medical Records (EMR) allows data to be recorded and stored on Dr. Feddema's laptop until a wireless connection is available when the files are securely backed up.
The full adoption of Electronic Medical Records (EMR) results in a very deliberate and necessary concern about system security and integrity, all of which is carefully overseen and audited by the provincial authorities. The Electronic Medical Records (EMR) provided by Nightingale operates out of a secured data centre and a virtual private network (VPN) established with the Calgary Health Region (CHR). The idea was to provide strict compliance with security objectives. There are multiple layers of encryption and password protection. In addition, the fob issued by the CHR automatically generates a random numerical access code every minute to the wireless office system. Passwords are automatically "timed out" every 90 days and the laptop is scanned daily against potential viruses or spyware. All of the requirements of the CHR's virtual system are met by Nightingale.
At the same time the two security systems (Nightingale and CHR) work together to allow for security and efficiency. "This combination allowed me access to lab services, diagnostic imaging, ER/specialist video conferencing, and its administrative resources."
"With
As a closing thought on security, Dr. Feddema added, "when I started my practice I went through three separate inspections. Alberta Health, The Calgary Health Region and Nightingale's own system analysts each did their own inspections and each time my system passed with flying colors. My system works for me. I just wish more doctors were moving towards a paperless office. It would be better for them, for patients and for healthcare in general."
Patient reactions
When she started her new practice Dr. Feddema had some concerns about how patients would react to the new Electronic Medical Records (EMR) system. People are used to receiving there healthcare in a certain way and resistance to change is understandable. Almost everywhere she goes, the reaction to the new system has been positive. In fact, the new system seems to be providing more information for the doctor.
"The patients seem to love the new system. They sit beside me as I enter the data and watch what is happening. They can ask questions and it seems to take some of the mystery out of the process. Often as we chat I discover things about a patient I might not have discovered in the traditional doctor patient encounter. I am learning more about my patients and they are getting more involved in there own health care. That benefits both of us."
Keeping costs in line
When Dr. Feddema started her one woman practice she knew she was giving up many of the economies of scale that a larger practice can provide. It was essential for the new practice that the systems she was working with be affordable.
"I have not only kept costs in line I have reduced them dramatically. My overhead is about one quarter of what it was in the former practice. As long as I have my laptop, I have my practice with me so many of the costs associated with a traditional medical practice don't apply."
In addition to the cost savings there is funding available through
Efficiency and quality care
The real success of any medical practice management is the quality of care and the efficiency of delivering medical services. So far, Dr. Feddema is more than satisfied with the results. "I had a good idea of what to expect when I started down this road and so far everything has exceeded my expectations. Much of my practice would be a great deal more difficult if I was still tied down to a paper system. Imagine if a chart, an x-ray or test result gets lost or misplaced. It isn't as if I can walk into the file room and find another copy. "
"I am often in very remote regions and if I don't have something with me there is no going back for it. An electronic medical records (EMR) system means I have it with me. I can show a patient an x-ray, test results and I can look up past medical history just with the click of a mouse. When you are working in rural areas it just doesn't get any better than that."
Moving Forward
As she incorporates more components of Nightingale On Demand into her practice, Dr. Feddema is confident that she is onto a winning formula.
As more and more physicians get online, she will be able to share patient data with specialists and other doctors and it can all be done in a secure environment where privacy is ensured.
"The ultimate goal is to be completely paperless and I am convinced I will be there very soon. My own system is already there and as more physicians get on board this system if going to change the way we practice medicine. Imagine a system where a specialist can be consulted immediately. I can send charts, test results and patient history and get a response in a few minutes. This has to be better for patients, doctors and because it is so much more efficient for the healthcare system in general. "
"Everyone knows this is the way to go, now it is just a matter of getting there and I want to be first in line."
