Practice 911

TMA Physician Services Will Answer the Call

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Member Services Feature -- April 2005  

By  Erin Prather
Associate Editor  

Paperless. Barbara Fogiel, MD, wanted her office to be paperless. After opting to start her own obstetrics and gynecology practice in Houston, she wanted to create a state-of-the-art facility.

"It's the direction medicine is going," she said. "Starting a practice from scratch has provided me with the perfect opportunity. As we all know, the hardest part about going paperless is converting your charts. I only had 500 to convert when I opened my doors in November."

Starting a new practice is one thing. Going paperless is another. Both can be daunting. Even after jotting numerous notes about what the practice would require, she questioned whether she was doing the right thing. Then she spotted a TMA Physician Services ad in Texas Medicine . She immediately picked up the phone. It was a good decision. She got help with both. 

A New Start

Dr. Fogiel is the first tenant of the space her practice occupies and she has taken a hands-on approach to its design. She enlisted the help of an architect and interior designer to give it a modern and warm look. Computers are located in every exam room, and Dr. Fogiel and her staff have chart access in all work areas. Using electronic medical records (EMRs) eliminates both the need for physical chart storage and the dilemma of misplaced charts. One study, published in the April 1, 2003, issue of American Journal of Medicine , estimates that not having to pull and file charts could save a practice $5 per patient visit.

"Being Paperless eliminates misplaced charts, something that creates inefficiency or delays," Dr. Fogiel said. "A patient's chart would go missing, it had to be found, and then I would be late meeting with that patient. It was a waste of both their time and mine. Now the chart can be pulled up on the computer in any of the exam rooms."

The computer allows Dr. Fogiel to save time documenting the patient's visit. She talks to the patient, then immediately enters the information into the computer system. That eliminates the need to document the visit after the patient leaves. A May 20, 2002, AMNews article suggested that using an EMR could reduce the average time needed to document an office visit from 20 minutes per patient to only four.

Furthermore, Dr. Fogiel hopes to save even more time by allowing patients to register their medical history online before visiting the office. She has been working with a professional on the Web site's design because she knows it is an imperative tool for recruiting new patients. A study by the Pew Internet & American Life Project reported that 21 percent of surveyed Internet users have searched online for information about a particular doctor or hospital. Dr. Fogiel hopes the site ( will be active this month.

"I ask all new patients how they heard about my practice, and most say the Internet. They discover my practice through their medical insurance site. I've also had a patient tell me they found my services through a search." 

Seeking Help

Dr. Fogiel is happy all of her staff members have acclimated themselves to the paperless system. However, when first opening the practice, she had no idea how to find qualified employees who could adapt to EMRs. Luckily, in calling TMA Physician Services, Dr. Fogiel tapped into a valuable resource.

TMA Physician Services provides full-service practice management consulting to help physician members meet operational challenges. In 2004, it helped more than 250 members in more than 50 practices. Of the services offered, practice set-ups were the most frequently requested. Most of these new practices are solo offices.

Dr. Fogiel's call to TMA Physician Services introduced her to director Peggy Pringle. At their first meeting Dr. Fogiel described the steps she had taken to set up her practice and areas where she needed help. Physician Services helped Dr. Fogiel find employees by advertising in the Houston Chronicle , sorting through 300 applicants to fill three slots, and conducting initial telephone and follow-up personal interviews.

Additionally, Ms. Pringle created a policy and procedure manual for Dr. Fogiel and conducted the employee training. She also distributed a large vendor book, which gave Dr. Fogiel names of reliable companies and recommended EMR services.

Dr. Fogiel is quick to say physicians should do their research when choosing a system for a paperless office. "There is so much software out there. I recommend narrowing the search by talking to physicians who already have a system. Ask what problems they had. Check to see if the company will provide you with appropriate maintenance of both the machines and software. I feel really lucky that Physician Services was there to present options to me."

At a sold-out seminar on EMRs during the TMA Winter Conference, Roland A. Goertz, MD, MBA, said the transition process for planning, selecting, and implementing a new computer system takes approximately six to 24 months. He would know, as his Waco clinic has used an EMR system for six years. Physicians need to keep their cool while converting from paper to electronic records, he said, because practice productivity will drop during the initial conversion, and it could take three to six months for productivity to return to previous levels.

Dr. Goertz also said physicians should review their practice operations, which will help them determine where computers could increase productivity. A workflow analysis will help physicians think through the functions they want from their EMR system and assist them in making an appropriate choice.

Dr. Fogiel is sold on both electronic records and the help she got from TMA Physician Services. "The help I got from Physicians Services was critical to starting my practice. Without their help I wouldn't have had such an easy transition. As for paperless, it's an ongoing process that is already saving me time. As my practice grows I know having a paperless system will continue to be a great benefit," she said. "It just takes a little getting used to. I highly recommend Physician Services to my colleagues." 

Erin Prather can be reached at (800) 880-1300, ext. 1385, or (512) 370-1385; by fax at (512) 370-1629; or by email at  Erin Prather.  

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