Urgently Ortho in San Francisco, California, had an overarching goal: to create a tech-enabled orthopedic urgent care facility that provided a seamless patient experience using technology that could scale with leadership’s growth ambitions.

THE PROBLEM

IT needed to be fast and efficient for providers to chart notes, and user-friendly for clinic support staff, said Liu Cheng, cofounder and COO of Urgently Ortho. Knowing that it might be difficult to find a single solution that solves all operational challenges, leadership also was looking for a solution that could accommodate third-party developers, should they need to expand outside of the core needs.

“We wanted an integrated practice management and electronic health record system to manage the entire patient experience,” he explained. “Specifically, we wanted an electronic check-in system and an easy-to-use patient portal to help eliminate paper from our workflow and improve the patient experience. Appointment reminders, scheduling, proper insurance verification and task management all are necessary to ensure we can deliver the best care to our patients.”

Most hospital EHRs did not offer a great patient experience. Urgently Ortho was looking for a modern solution that was aligned with the brand it wanted to create, he added. This included Apple compatibility and cloud-based systems not tethered to a server, and not needing to rely on an IT department for implementation or maintenance.

On another IT note, with the onset of COVID-19, it was imperative to quickly implement a telehealth solution that could integrate seamlessly with the current IT set-up and help the clinic meet the needs of remote patient care.

"Our fears of provider implementation and adoption were easily quelled with such a simple and seamless integration. Our providers were extremely comfortable with the system, and in under a week we were already familiar with both platforms."

Liu Cheng, Urgently Ortho

“The lockdown in San Francisco caused a 60% decrease in in-person visits overnight,” Cheng reported. “Prior to the pandemic, we were reluctant to trial telehealth because of fears of low patient adoption, lower reimbursement rates, and questionable effectiveness in the musculoskeletal specialty – since physical exams and X-rays must be done in person.”

PROPOSAL

On the practice management and EHR front, where other vendors separate these products, the DrChrono platform offers seamless integration of both, Cheng said.

“We had evaluated 15 EHR products prior to deciding on DrChrono’s platform,” he recalled. “The patient portal looked much better than existing products at the time. DrChrono was the only company to have an iPad app developed for the provider, which is great for keeping our providers mobile and not tied down to a specific workstation.”

The vendor addressed all of Urgently Ortho’s concerns, and leadership had high confidence prior to implementation that the vendor’s cloud-based solution would be able to address and automate the clinic’s patient workflow.

To address telehealth needs, the clinic decided on the NextPatient telehealth app used in conjunction with the DrChrono platform to manage patient data and conduct virtual visits, which have increased greatly since the pandemic.

“NextPatient is like a digital front office, fully integrated with the DrChrono offering’s advanced mobile capabilities to manage patient information, patient check-ins, scheduling, charting, medical billing, telemedicine and overall EHR management,” Cheng said. “This helps our staff better communicate with our patients remotely and operate our practice efficiently with the ever-changing status of the pandemic.”

MARKETPLACE

There are many vendors of telemedicine technology and services on the health IT market today. Healthcare IT News recently compiled a comprehensive list of these vendors with detailed descriptions. To read this special report, click here.

And there are many vendors with electronic health records systems on the health IT market, including Allscripts, athenahealth, Cerner, DrChrono, eClinicalWorks, Epic, Greenway Health, HCS, Meditech and NextGen Healthcare.

MEETING THE CHALLENGE

Implementation of telemedicine went quickly. Patients receive automated reminders and customizable instructions to sign into their telehealth appointments.

“NextPatient provides a simple and easy way for providers to connect with new and existing patients while staying safe during the pandemic,” Cheng said. “Patients receive a link that they simply click on to begin a video call with their provider on a desktop computer, or, if the patient wishes, the video call can be conducted via the NextPatient app available for both Apple and Android smartphones.”

Given Urgently Ortho’s diverse patient population, it is imperative that the video visits be easy to access so patients do not need to waste time creating multiple online accounts to access care securely. NextPatient, alongside DrChrono’s online patient check-in capability, has been essential to the clinic’s ability to continue serving patients during this difficult time, Cheng said.

“Our fears of provider implementation and adoption were easily quelled with such a simple and seamless integration. Our providers were extremely comfortable with the system, and in under a week we were already familiar with both platforms,” he added.

RESULTS

Patient volume is one of the most important metrics for any medical practice. In the early days of the pandemic, virtual visits took up roughly 30% of Urgently Ortho’s overall volume. Without virtual visit capacity, the business would be much worse off.

“As the pandemic becomes our new normal, we’ve seen many patients opt for a virtual assessment of their musculoskeletal injury first, and then decide if an office visit is necessary for a physical exam or X-rays,” Cheng explained. “The solution we have in place is making it easy for our patients to easily engage in a virtual visit when necessary.”

Additionally, the clinic has noticed its virtual visits enable it to run on schedule.

“We pride ourselves on running on time. However, traffic, rain and ‘My Uber cancelled on me’ [contribute] to late patient arrivals that make our schedule run behind,” Cheng observed. “We have observed that virtual visits tend to start and finish on time, because people are spending more time at home. Virtual care also allows us to maintain patient relationships while patients are traveling temporarily or moving permanently.”

Some other examples of how Urgently Ortho’s telehealth solution is helping treat patients virtually:

• There has been an increase in telehealth visits with an orthopedic specialist to assess injuries that typically would have been done initially as an office visit.
• It was important to educate patients on the benefits of a telehealth visit to assess a particular injury first and then decide if an office visit is necessary for a physical exam and/or X-rays. The telehealth solution is making it easy for patients to engage in a virtual visit when necessary.

ADVICE FOR OTHERS

“In today’s healthcare environment, medical practices need an efficient, reliable EHR to practice medicine in the years to come,” Cheng advised. “An EHR platform that not only solves your core practice needs, but also cultivates a third-party app-developer ecosystem, will help future-proof your tech-enabled medical practice.”

When considering a telehealth solution, ease of use and seamless integration with current systems is imperative, he added. Consider different perspectives on how patients, providers and front office staff all interact with the system, he said.

“While the product itself is important, another critical component to your practice’s success is the implementation and ongoing responsive, efficient support,” he concluded. “When evaluating new technologies, a big component of the team behind the tech can also factor into your decision-making.”

Twitter: @SiwickiHealthIT
Email the writer: bsiwicki@himss.org
Healthcare IT News is a HIMSS Media publication.