It’s been eight years since James L. Holly, MD, co-founder, CEO and managing partner of Southeast Texas Medical Associates, roamed the exhibition hall at the annual Medical Group Management Association’s annual meeting. As he tells it, when he tried to imagine what an electronic medical record might look like, “no picture came to mind.”

Fast-forward a few years, and the picture comes into sharp focus for Holly.

On Feb. 14, the Healthcare Information and Management Systems Society will honor Holly and his colleagues for putting their electronic medical record to work on delivering better care. The society will recognize SETMA as one of three medical groups across the country that deserves the coveted Nicholas E. Davies award. The other two in ambulatory care are Sports Medicine and Orthopedic Specialists in Birmingham, Ala., and Wayne Obstetrics and Gynecology in Jessup, Ga.

“We’re proud, and we’re humbled,” said Holly. “The Davies Award is the most prestigious award available in the nation for healthcare utilizing electronics.”

After examining more than 60 separate offerings, in March 1998 SETMA chose an electronic health record system and practice management technology developed by NextGen Healthcare in Horsham, Pa.

SETMA is a multi-specialty clinic with 32 providers at three connected sites in Beaumont, a city of about half a million people just 30 miles upstream from the Gulf of Mexico. The practice’s medical record system pulls together office visits, lab results, hospital history and specialty care data. SETMA also plans to enable patients to schedule appointments online and expand the service to targeted specialty care groups - to patients with diabetes, for example.

“The best way to treat diabetes,” said Holly, “is don’t get it. Electronic systems make it possible for clinicians and patients to monitor some of the key contributors - weight, inactivity and smoking.”

Even before Holly knew what an electronic health record could do, before he could imagine what it might look like, he knew that 21st century medicine was too complex to do with paper.

“Paper is too cumbersome,” he said. “We always transcribed. We were always behind. There was no way we could do complex decision-making. We were practicing 21st century medicine with 20th century technology.”

The EHR reaped financial rewards for SETMA as well. The technology paid for itself in less than two years. The savings included $340,000 in annual transcription costs and $120,000 for handling paper charts.  More accurate coding and charge capture increased collections by $1.4 million.

For SETMA, the Davies award follows a particular trying year that brought a lawsuit by one of the partners (settled in favor of SETMA), the loss of several key employees to a new start-up company, and hurricane Rita.

So, it’s no wonder that Holly is particularly gratified by the recognition - not just the award itself, but the comments of committee members on their site visit on Sept. 15, 2005.

- “When we saw your application, we assumed that this was an exaggeration, but now that we have seen what you are doing, it is not.”

- “ You have taken disease management farther than anyone we have seen.”

- “I have always assumed that every implementation of an ambulatory EMR is essentially the same; you have proved me wrong.”

- “You say that you are pursuing excellence, you may not have achieved perfection, but you have surpassed excellence.”

There are several other projects in the works as SETMA strives to beat its personal best. The practice is establishing a research department. It plans to provide data to demonstrate best practice in diabetes treatment. It is working on creating a library for providers.

At 62, Holly can’t wait to get to work every day. He anticipates a bright future, but the picture is fuzzy.

“Where we’re headed now, we don’t know because we don’t know where our imagination will take us.”

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Nicholas Davies

The Davies program honors Dr. Nicholas Davies, an Atlanta-based practice physician committed to the ideal of improving patient care through better health information management. He was a member of the Institute of Medicine Patient Record Study Committee, which coined the term “computer-based patient record.” Davies was chairman-elect of the American College of Physicians. In April 1991, he was killed in a plane crash with Sen. John G. Tower (R-Texas).