When Dr. Thomas Miller, a family care physician and owner of Family Medicine in Arlington, Texas, started using EHRs, many other practices still were using paper records and operating their practices without the benefit of much technology.

Miller was an early adopter when he implemented his first EHR for his solo practice in 2003.

THE PROBLEM

"Eventually, the solution I was using at the time, SOAPware, went out of business," Miller recalled. "And so, I was in the market for a new one. However, I not only wanted a new electronic record system for patients and care, but also a solution that would allow me to run my practice smoothly.

"I have been in independent practice for almost exactly 30 years," he continued. "I only have two employees – someone at the front desk to manage the practice, and my nurse. So, I really rely on technology to help keep us running."

On another note, Miller had issues with the billing software he was using. He wanted to mitigate that since it was such a hassle, requiring staff to double-check claims and manually add information. Because of that, it also was important for Miller to ensure that aspect of the business was improved upon with whatever technology, or set of technologies, he would adopt.

PROPOSAL

Miller turned to vendor AdvancedMD in part because it offers what for him is an all-in-one package.

"They offer the practice management solution, the EHR, the billing, the patient portal – literally everything I need to run my practice," he explained. "I even use them for faxing documents. It's kind of amazing, considering how piecemeal early practice management solutions tended to be. They were an ideal replacement because of the comprehensive nature of their offering."

"My advice to anyone in independent practice is to try to stick to a single platform."

Dr. Thomas Miller, Family Medicine

"Also, I am pleased to say patient billing is now a lot better," he added. "Our previous solution was not as automated as it should have been. There were always snags, and sometimes, it took a lot of extra time to get properly reimbursed."

The new system sends out all claims automatically at 7 p.m. every evening, and the entire process requires much less work on the part of staff. Information from the EHR flows into the practice management system automatically, and what staff needs for reimbursement is right there.

"Everything is streamlined, and it requires less manual work, which for a small practice like mine means we save money and time," he noted.

MARKETPLACE

There is a wide variety of electronic health record vendors on the market today, including Allscripts, athenahealth, Cerner, eClinicalWorks, Epic, Greenway Health, Medicomp Systems, Meditech, Medsphere Systems and NextGen Healthcare.

MEETING THE CHALLENGE

The new system is very adaptable and plays well with others, Miller said.

"For example, in March 2020 when the pandemic hit, I was seeing a lot fewer patients in person," he recalled. "I quickly adopted a telemedicine solution, Doxy.Me, because it was quite affordable and available on every app store. While it's not an AdvancedMD offering, I had such little trouble implementing telemedicine into my practice that, two years later, I still see patients virtually.

"Telemedicine offers me a chance to see patients who either can't or don't want to come into the practice," he continued. "And it also allows me to see patients when I am at home, using practically any device. It's been a great source of convenience and new revenue for us – and it makes delivering care to patients a lot more flexible."

Miller then can see the patient virtually and do what he always does – add their information into the new system, care for them and bill as normal.

"It's been a big change, but because my practice runs smoothly, I have weathered the pandemic slowdown a lot better than others have," he said. "I plan to stay independent forever."

RESULTS

Miller's practice is small, and he doesn't have the time to delve into things like hard success metrics, he said.

"But what I can say is that I am not working in the evenings anymore, except on rare occasions," he noted. "I leave the office earlier, I have more free time, and overall, the practice operates more smoothly. That means I am able to do what I do best, and that is care for my patients. At the end of the day, that is the goal of any independent practice. Any technology a practice adopts should facilitate that.

"My staff is also less stressed," he continued. "They have less work to do because everything from initial scheduling to billing is all conducted through AdvancedMD, and all of their offerings talk to each other perfectly."

Miller has seen some of his patients for many years. He says they're much happier because they get more one-on-one time with him, and they can schedule appointments online through the patient portal, fill out any necessary paperwork ahead of time, and not have to wait once they get to the practice.

"Everyone is happier, and I can really live up to the Family Medicine name of my practice," he said. "This is incredibly important to me as it becomes harder and harder to remain independent – with small practices like mine squeezed in the middle and pressured to join larger groups.

"Efficiency matters," he added. "And so does the happiness of the one doctor seeing patients, not to even mention my nurse and administrator, who help to keep me and this practice on track."

ADVICE FOR OTHERS

One thing Miller learned the hard way is if one has a billing or practice management system that is not compatible with an EHR, even if things are working, one day all of a sudden, those systems will not be compatible anymore, he said.

"Good luck with customer support because each system will just blame their competitor," he said. "So, my advice to anyone in independent practice is to try to stick to a single platform."

Twitter: @SiwickiHealthIT
Email the writer: bsiwicki@himss.org
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