The Eye Care Center of Northern Colorado needed to implement a new EHR because its previous EHR implementation, one year prior, left staff and clinicians underwhelmed. The old EHR and practice management system from a well-known vendor seemed promising at the time, but quickly proved ineffective.

THE PROBLEM

"The group discovered the software did not have the functionalities we expected, and the primary pain point came from billing," said Megan Hamilton, clinical director of The Eye Care Center of Northern Colorado. "Issues included payments not posting, or patients receiving the same bill three or four times.

"We also saw insurance adjustments fail to apply to a patient's bill, and the patient would receive a bill for the wrong amount," she continued. "I personally purchased a pair of glasses from our office and received multiple bills and phone calls to collect money I didn't owe. So I saw firsthand the frustrating system our patients had to deal with and knew we needed to make a change."

Other functionality issues created inefficiencies in the practice. For instance, The Eye Care Center of Northern Colorado has 14 providers across four locations. The old software's practice management system made it difficult for staff to sort providers by location.

Also, it required 12 clicks – a very high number – to add one insurance card to a patient's billing profile. If the patient had two insurance cards, that added up to several minutes of time on one patient intake, and led to longer wait times.

"Those inefficiencies also extended to patient charting," Hamilton noted. "If one patient saw two different specialists in our practice – for instance, a retina appointment followed by a glaucoma appointment – the glaucoma specialist could not easily pull the notes from the retina visit, and vice versa.

"After compiling each of these issues, our team built a 15-page report detailing every one," she added. "We implemented the original EHR in June 2022, and by January 2023, we made the decision to switch."

PROPOSAL

While Hamilton acknowledged the difficulty of asking physicians and staff to undertake a second EHR and practice management implementation in a year, the team knew practices needed a change. They selected EHR vendor ModMed.

"We felt confident in the plan ModMed offered because it was inclusive of each of our pain points and offered familiarity, as some of our physicians had previously worked with its systems," Hamilton explained. "The plan laid out exactly how it would address our most critical issue – billing. We did not need to add new bells and whistles when it came to the billing process, we simply needed reliability.

"The vendor's revenue cycle management system promised to deliver the foundational reliability we lacked, working efficiently with our insurance partners to send our patients accurate billing statements," she continued.

The new system also offered hands-on support from its trainers and a dedicated project manager. Staff and clinicians participated in weekly virtual training sessions, followed by a week of on-site training.

"We also had a variety of virtual sessions for specific staff groups, such as MAs and physicians, allowing for additional dedicated training time for staff groups with more complex tasks," Hamilton noted. "The resources from the vendor gave our staff the flexibility to complete training on their own time and made the process relatively painless.

"This level of support also factored heavily in our decision to make a second EHR switch in a year, because we knew our team would appreciate a strong training mechanism," she added.

MEETING THE CHALLENGE

Each staff member knows what their job entails and the duties that go into their respective roles, they just need a vessel to make those tasks happen, Hamilton said. The new systems have design elements that make each member of staff feel like the developers built the software with their unique needs in mind, she added.

"For instance, the revenue cycle functions seem designed by someone with billing experience, themselves," she said. "This is a major upgrade from our previous experience.

"EHR functionality should never limit our practice's ability to treat patients and it is much easier now to complete tasks when the system works as intended," she continued. "While we had to re-work many of our workflows to adapt to the new system, that was much less painful than trying to make a broken system functional. We, as a practice, have whiplash from trying to put band-aids over our previous EHR to compensate for its inadequacies."

ModMed integrates with a drug management platform called PODIS, which helps to reconcile the eye center's large volume of retina injectable inventory. It also has an integrated patient engagement platform, called Klara, which offers two-way communication with patients and a reminder system to keep patients on time for their appointments.

RESULTS

"We have seen measurable results across the board that have resulted in tangible benefits for our patients," Hamilton reported. "For instance, the 12 clicks the old EHR required to add a new insurance card have been reduced to one click. This efficiency already has elicited feedback from patients who comment on how fast the intake process has become.

"Patient charting also has seen a significant streamlining," she continued. "Documentation for a repeat patient can take as little as 30 seconds in the new EHR, called EMA, a reduction of more than two minutes. Extrapolating that efficiency for each patient, our care providers are saving one hour for every 30 patients they see – a tremendously valuable amount of time."

Further, physicians now have access to notes from other specialists – allowing them to seamlessly pull data on patients from their visits with another specialist. In addition to saving physicians the time and effort of asking another specialist to share their notes manually, it has improved the patient experience by giving physicians the most relevant patient data at their fingertips at the time of each visit, Hamilton said.

"Inaccurate billing issues, the primary impetus for our new EHR search, have been completely resolved," she noted. "ModMed's revenue cycle system promised reliability and it has delivered an extremely high degree of accuracy and reliability. Our patients no longer receive duplicate bills and the system accurately applies insurance adjustments to each bill, as appropriate."

ADVICE FOR OTHERS

"If a new EHR is not working well for your practice, have the decisiveness and conviction to change course and find something better," Hamilton advised. "The extra time and effort required for a new implementation are completely justified when the incumbent system drags down efficiency and impacts the quality of the patient experience.

"The value of training support cannot be overstated, especially when asking clinicians to move to a new software suite shortly after another one," she concluded. "Flattening the learning curve and making the onboarding process as smooth as possible will inspire buy-in from the entire team and help them realize the benefits of the new system faster."

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