Adopting an Integrated EMR Improves Practice Workflow, Transforms Care

Physician practices have become increasingly complex, with data management needs competing with patients for time and attention. In response, physicians are seeking better, more efficient ways to manage patient data, improve revenue cycles, run real-time reports and streamline day-to-day operations. However, finding workable practice management and electronic medical record (EMR) solutions to meet these goals successfully has not been easy.

“Physicians are making less money than they have in the past, their expenses are higher and their work-life balance is tipping in the wrong direction,” said Russell Keene, Vice President, Ingenix CareTracker Technologies. “It is clear that the technology industry has to do more to help relieve physicians’ burdens.”

In Keene’s view, the industry is at a crossroads as it develops options that will simplify the administrative and clinical tasks in a physician’s practice. “One approach is to throw more money at the problem, which historically has been done to minimal effect,” he said.
Additionally, “the past practice of changing one element or application at a time is simply not working and tends to complicate, not simplify, the situation.”

Ingenix believes that the best way to help physicians both survive and thrive in the current environment is “to transform the underlying infrastructure with a comprehensive and flexible system that helps physicians take better control of their practices,” Keene said.  

Practice goals include quality of care, EMRs

A recent leadership survey conducted by the Healthcare Information and Management Systems Society (HIMSS) found that the number one health care business issue for 2008 is improving quality of care. Also, the top two IT priorities for outpatient health care are: (1) reducing medical errors and promoting patient safety, and (2) implementing an EMR.¹

The challenge in meeting these goals is making the collection, integration and monitoring of increasingly complex data part of one seamless system. This is not an easy task when you consider that in a typical day, physicians manage hundreds of pieces of data from disjointed sources and in multiple formats, Keene asserted.

What the health care industry is seeking is an easily accessible electronic system that coordinates the storage and retrieval of individuals' health records, increases efficiency, reduces costs and promotes standardization of care.²  However, in an op-ed piece published in The New York Times last year, the author wrote: “Health care providers have been dreaming about electronic records for so long that the idea has begun to seem like vaporware, a never-to-be-realized fantasy similar to flying cars and jetpacks.”³ 

To make effective and user-friendly EMRs a reality, improve physician quality of life and drive down costs, practices need an integrated system that works in tandem with its practice management system (PMS) data to easily make determinations regarding insurance eligibility, co-pays and prescription drug coverage.

“When the PMS and EMR systems are not integrated, you have to populate the databases using manual or awkward solutions,” Keene said. “This can be very expensive and labor-intensive.”

Ingenix is solving the EMR and integration problem for physicians with Ingenix CareTracker, a web-based practice management, EMR and revenue cycle management service that fuses clinical, billing and administrative workflows together. Ingenix acquired Keene’s company, LighthouseMD, in August 2007, and has enhanced the original CareTracker applications by integrating them with Ingenix coding and compliance solutions. This enhancement is significant, Keene explained, because the manner in which physicians secure payment for services has become increasingly complex.

“In the past, a doctor would provide care and either the patient would pay or the doctor would bill the insurance company and be paid,” he said. “Now being paid is much more complicated, taking into account prior authorization, complex coding, disparate data sources such as specialists and labs, and varying co-pays.”

Integration and ease-of-use are the keys to success

Keeping track of patients’ clinical and insurance data is a time-consuming endeavor that can bring a physician’s practice to a grinding halt, according to Keene. “What Ingenix CareTracker does is to put crucial patient data – including clinical, insurance and billing information – at the practice’s finger tips,” he said. “Removing the clutter from the practice’s operations allows providers to take better care of their patients and run their businesses better.” He also noted that stand-alone applications often have inherent data redundancy and integration problems and require frequent maintenance and monitoring.

“To be successful, EMRs need to be easily integrated into practice workflows or they will be disliked and abandoned,” Keene pointed out. “CareTracker’s strength is its flexibility in accommodating any practice workflow.” When building CareTracker, Keene knew that any workable EMR system would have to dovetail with the PMS and would not solve the practice’s problems unless it could automate key processes and offer superior connectivity.

“I think we’ve seen over the years that EMRs without connectivity don’t really help much. Physicians want an integrated system that that is accessible remotely and connects them to the stakeholders with whom they do business,” he said.

Further, Ingenix realizes that managing patient data – in both paper and electronic forms – “doesn’t get fixed by EMRs,” Keene remarked. “However, it does get fixed by a model that connects physicians quickly to the information they need, such as eligibility status, prescription drug co-pays and evidence-based medicine triggers.”

Saving time, money with integrated systems

With CareTracker, authorized users can log-in to their EMR and PMS systems via a secure Web browser using a PC or laptop. Once logged in, they can access patient records and review medications, patient history, recent orders and test results.
According to Keene, using CareTracker gives physicians the advantage “of flipping right to the one page you need to help you make a decision, instead of having to read an entire book.”

Because CareTracker’s EMR features are fully integrated with its practice management applications, practice managers also can remotely review staff allocations and appointment schedules. To illustrate Ingenix CareTracker’s myriad functions, Keene described how a practice office manager would benefit.

Arriving at her desk in the morning, the office manager would log in to her system and review her dashboard. Overnight, the application automatically:

• called every patient to confirm their appointment;
• verified each patient’s eligibility;
• captured the patients’ insurance policy detail;  
• gathered all the charges entered during that day, scrubbed them against powerful claims editing tools and billed them electronically;
• checked the status on every claim it billed three days ago to confirm they were on file and set to pay; and
• built and delivered personalized work lists for each member in the practice.

Ingenix CareTracker also can help improve patient care by automatically flagging patients who have not scheduled the routine tests or follow-up visits required to manage their conditions. “Finding those patients to make sure that you bring them back to the practice and ensure that they don’t slip through the cracks is a lot better for the patient. If you can achieve that without a great deal of expense, it also can drive revenue for the practice,” Keene said.

CareTracker also can make the practice more productive because it automates many necessary but time-consuming tasks so staff can focus on big picture issues, problem areas and direct patient care. “Allowing staff to take action on all sorts of issues, be they patient protocols, claims or scheduling – before they become problems – can save both time and money and significantly improve the practice workflow,” he added.

Setting up CareTracker is easy and flexible because of its ability to accommodate varied practice workflow models. Daily operations are not interrupted during the transition because CareTracker is accessed through a Web browser; there is no need to reconfigure existing practice hardware. Ingenix also provides a suite of services, including support, implementation, training and reporting, that help physicians get their practices back on an even keel and keep them that way.

“Because we update and enhance the CareTracker products seamlessly, physicians have continuous service that addresses and refines the solutions. The backbone of Ingenix CareTracker includes applications that you never see, which never expire and never interfere with your office protocols,” Keene concluded. “We work at engineering out the complexity, so physicians can focus on what matters.”

For more information on this Ingenix solution, visit www.ingenix.com/caretracker or contact us at engage@ingenix.com or 866-427-6802.

1. 19th Annual 2008 HIMSS Leadership Survey, CIO Results Key Trend Index (Feb. 25, 2008).
2. Hampton, Tracy, PhD., “Groups Push Physicians and Patients to Embrace Electronic Health Record,” Journal of the American Medical Association, Vol. 299 (Feb. 6, 2008).
3. Goetz, Thomas, “Physician, Upgrade Thyself,” The New York Times (May 30, 2007).

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