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Ten years ago, when Melissa Lucarelli, MD, installed a practicemanagement software system for her Randolph, Wisconsin, familypractice clinic, she used its billing function as soon as thesystem went live. She encountered some unexpected problems and soonfound she was 90 days behind in collections. She had to take out anemergency loan to keep her practice afloat. That experience has helped Lucarelli as she prepares now toimplement an EHR system (McKesson). She uses the system to bill forjust a few small procedures each day. "I'm a lot smarter now," she says. [RELATED: EHR Best Practices Study aims to gather real-world data, solutions Survey documents EHR implementation costs Announcing our EHR Study Meet the physicians ] The take-it-slow approach also has been forced on her to someextent by being a pioneer, because hers is the first practice touse the particular system. "We're basically beta-testing a product," she says. "We'll get to ascreen that has a problem and the vendor representative will say,'Oh, so that's not working yet? Let me send that to development.' " Despite the frustrations, Lucarelli is excited about the system'spotential to make her and her 12 employees more efficient andbetter able to care for their patients. Using the system inconjunction Microsoft Office 365 is enabling her to move bothpatient records and office documents onto either Microsoft's or theEHR vendor's cloud site, with the ultimate goal of making thepractice nearly paperless. "We're totally redesigning our work process," she says. Among otherimprovements, Lucarelli anticipates the system will reduce the timeshe and her staff spend tracking down patients' charts. Inaddition, it will enable her to access patient information fromhome and strengthen the clinic's data security. "I really wanted a cloud-based product," she says. "My ideal worldhas no [Health Insurance Portability and Accountability Act] dataon site, and if my clinic burns down, all my patients' data arestill secure. And that's what this product is supposed to be ableto do. We're just not there yet." All those benefits have come at a price, however. Lucarelli tookout a $31,000 bank loan to cover the costs of the requiredhardware, and nearly every one of her 12 employees is workingovertime in preparation for the system going live. Lucarelliestimates that the clinic's manager spends 50% of her workday onEHR-related issues. The clinic also has hired a part-time employeeto scan patient records and other documents into the system. "That's something people need to remember [when estimating an EHRsystem's cost]," she says. "It's not just the hardware, thesoftware, the licensing. You'll probably need to add payroll, andyou won't be getting extra money for that." Lucarelli meets regularly with her staff members to update them onthe progress of implementing the system and to brainstorm solutionsto common problems. "We've been trying to look at this as anadventure," she says. "It will be fun to see where we are in thenext 6 months. I'm optimistic that we are going to attest (formeaningful use) by the end of the year. It is going to happen." ALSO IN THE SERIES Doris Tummillo, MD: Adding decades of data worth the effort James Borges, MD: Progress means changing workflow Andrew Garner, MD: Rely on a scribe to improve efficiency. I am an expert from softenerflakes.com, while we provides the quality product, such as Silicone Thickening Agent Manufacturer , Nonionic Softener Flakes, Nonionic Softener Flakes,and more.
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