Nudged Into the Future by an E-mail
Reavis T. Eubanks graduated from medical school in 1971 and finished his residency in 1976. He has practiced as a surgeon and primary care physician in Asheville, N.C. ever since. He's had the same office manager for 30 years. Now 65 years old, he hopes to practice for another 10 years. He sees about 200 patients a month and after 35 years serving the same community, Eubanks has quite a collection of paper charts.
That collection has been dwindling one patient at a time since early 2011 when he began transferring charts into athenaClinicals, athenahealth's cloud-based EHR service.
He had never used an EHR before. And he would not have bothered except for an e-mail from athenahealth in the summer of 2010 educating physicians about the HITECH Act. He received the e-mail after registering for and watching one of athenahealth's free webinars, all part of a major effort by athenahealth to get eligible doctors up to speed on Meaningful Use and equipped to earn up to $44,000 in government incentives.
"It was obvious from the information we'd received in the e-mail, that three years down the road you'd have to do it," he says. "So it made all the sense in the world to press ahead now." Press ahead he did.
He followed every step to understand how the program would flow. He attended every athenahealth Meaningful Use webinar. He attested to the measures at the end of June 2011 and he expects to receive his $18,000 check in late summer. "I basically stumbled into it but I am very glad I did," he says.
Cloud-based Service Makes Meaningful Use Easier
athenahealth is well-positioned to secure Meaningful Use and other quality incentives for physicians like Dr. Eubanks thanks to the cloud-based services provided through athenaNet.
New enhancements are enabled every seven weeks on athenaNet. Because it's a centrally-hosted solution, athenahealth can apply an upgrade—such as adapting Meaningful Use measures—and all clients are on updated software the next time they access the system. The Quality Management Engine in athenaClinicals surfaces the clinical guidelines at the right point in the workflow, to ensure that the right data is captured and actions are taken to receive incentive dollars.
In addition to responding to changes like Meaningful Use by installing a provider dashboard or connecting to immunization registries on behalf of providers, athenahealth also serves as a client proxy in contacts with the Centers for Medicare and Medicaid, saving them time and hassle.
When Eubanks relocated from his office of 34 years, he had to fill out a 24-page change-of-address form for Medicare that took three submissions to be accepted. After that experience, it became clear that having athenahealth step in as proxy to the government would free him from the mind-numbing administrative burden he expected on the path to Meaningful Use.
As he worked through the measures in the spring of 2011, he also found that meeting Meaningful Use has proven "very beneficial" to patient care because the required steps can open up dialogue that did not previously exist.
Eubanks always made it a practice to meet with new patients in his office before their first exam, but now he has a second meeting afterward to go over his thoughts and treatment plan. And to address one of the Meaningful Use measures, he also provides a clinical summary so patients leave the office with an account of their visit in hand.
"I don't want to just tell you smoking is not good but it's not good because you also have vascular disease or diabetes or whatever and then be able to point to a program in the community," he says. "Some people are really looking for an opportunity to get help."
He values the steps for medication reconciliation, weight checks and electronic prescriptions that are required as part of the Meaningful Use measures. Also, a section of the clinical summary reminds him what he has not yet done to satisfy any measures. He's found that providing patients with pertinent information from HealthWise has been easy. He also finds the EHR very adaptable to his (very recently paper-based) workflow.
"In essence, I think it's a good idea and if we embrace it, we can help our patients and help each other," he says.
Keeping a Promise and Covering Costs with EHR
Eubanks has always enjoyed computers, so attesting to Meaningful Use of his EHR wasn't so much about mastering the mechanics of the computer but the mechanics of the government program.
Despite his interest in electronics, the EHR software he had often seen demonstrated at county medical society events was far too expensive to buy. Before 2010, he had no idea that a cloud-based service like athenahealth existed. All he had heard were "horror stories" from local colleagues who spent $60,000 on EHR software, only to learn later that it was not certified for Meaningful Use. Those doctors had to start over.
For Eubanks, the cost of software solutions would have turned him away and left him with his paper charts. "As a solo practitioner, that would not have been a very doable thing. At this point in my career and being solo, it makes much more sense to do something that's web-based as opposed to something with a lot of up-front costs," he says.
Years ago, his own child required care at the Texas Children's Hospital. It was an eye opener for him as a parent, and from then on, "my goal was to be available for my patients."
Now, the anytime, anywhere access and convenience of being on the cloud-based EHR, athenaClinicals, has allowed him to stick to his promise.
"It's concise. It's available. If I have a patient calling me at home I can pull up the record at the house. It's so much easier," he says. "The whole thing has been very rewarding."
