Practice Partner User Profile -- Foundation

Skagit Valley Medical Center is a 55-doctor organization located 75 miles north of Seattle. Like many medical organizations, Skagit Valley Medical Center saw the benefit of implementing an EMR system but didn’t have the resources to initiate a full project. They decided to take an incremental approach to an EMR by implementing the Repository Option of Practice Partner Foundation.

They have installed Practice Partner Foundation at a 7-doctor Internal Medicine clinic, which will serve as a the pilot for the project. The central billing office was also given access to the Foundation product.

Workstations were installed at the Internal Medicine clinic in each doctor’s office, at each triage nurse station, and at the medical assistants’ station. Because the central billing office already had a network infrastructure, no additional hardware was required for the billing staff.

Incorporating Practice Partner Foundation into daily practice was easy. The providers at the practice were already using dictation to record patient visits, so there was little change to their normal workflow. Additionally, the practice had been saving their past transcription on file, allowing them to upload the past six months into the system. This helped improve the utility of the repository approach from the first day since the transcribed files contained a significant amount of clinical data. Because the providers did not need to change their workflow to incorporate the use of the note viewer, there was almost no learning curve associated with the application. After the provider finishes a visit and the associated dictation, the tape is sent to the transcriptionist to transcribe into a progress note.

To incorporate the dictated notes into the viewer, the transcriptionists were trained to add markers (dot codes) into the transcribed notes, allowing them to populate the note viewer. The note viewer will then not only display progress notes, but also allows the information contained in the notes to populate certain sections of an electronic chart. In addition to historical progress notes, the practice currently uses the software to track prescriptions, major problems, and allergies—all of which are updated from the progress notes via the dot codes.

The project has had a positive impact on the entire practice. Because past progress notes are available via workstations, the need to find and pull paper charts to look at historical notes is virtually eliminated. This is beneficial for both the clinical and administrative departments, as there is never a struggle for a patient’s chart. This type of access is especially helpful for the triage nurses. When a call comes in, they can respond on the spot without searching or putting the patient on hold because the last notes are immediately available, without searching or putting the patient on hold. The nurses have also found that having access to the most recent notes has been helpful in structuring internal quality assurance of documentation.

The same access is beneficial to the billing clerks as well. Prior to implementing Repository, the billing clerks were last on the list for chart requests, resulting in delays on billing issues that required past notes. With immediate availability to historical notes, the billing office is now able to more efficiently process and negotiate claims without having to wait for the actual chart. Repository also makes it much easier for the billing office to create printed copies of the notes for those payers that require it.

The providers have also found value in this approach. With workstations in each office, past progress notes are available when and where they are needed. This is especially valuable when the latest note needs to be reviewed. Because the transcribed notes are entered into the system as soon as they are completed, they are immediately accessible. Prior to implementation, the providers would need to wait for the transcribed notes to be assembled in the patient paper chart. Additionally, the patient’s medications, allergies, and major problems are tracked, allowing for a quick patient overview.

In the future, Skagit Valley Medical Center will add laboratory and hospital interfaces. These interfaces will allow lab results, admission and discharge summaries, and other information collected at laboratories and the local hospital to be inserted directly into the Repository software. With these additions, the organization hopes to roll out the product across all of their practices.

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