GE Healthcare
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Associated Physicians for Women, PLLC

Solution overview

Company profile

Founded in 1996, Associated Physicians for Women in Richland, Washington, has grown rapidly to become – as their website address says – "All Things Women" (allthingswomen.com). The practice includes seven physicians, three other providers (midwife, nurse practitioner, and physician’s assistant), and a licensed mental health counselor. The practice even offers laser treatment for spider veins and hair removal. Obstetrics and gynecology remain the primary focus of this practice; APW’s providers delivered 1,100 babies in 2002.

Situation

Associated Physicians for Women has used Centricity® Practice Management very successfully since April 2000. After using Centricity to make their appointments, billing, and collections as efficient as possible, the doctors turned to the next challenge: finding an electronic medical record system. Their goals were to improve patient care, make record-keeping more efficient, and use the power of computerized expert systems to support care decisions. Their other priority was to find a system that could be integrated with Centricity Practice Management to create a paperless office.

Business solution

APW selected GE Healthcare’s Centricity Electronic Medical Record (EMR). The system was implemented in February 2003, with the help of Healthco Information Systems, on a wireless network that uses laptop computers, thin-client terminals, and tablet PCs with handwriting recognition. The doctors carry the tablets as their primary computer, replacing a workstation, laptop, and PDA. The practice’s extensive wireless network allows providers to access the network from anywhere in the office; soon, they’ll be able to leave the building and walk across the street to the hospital without ever losing the connection.

Note
In March 2002, Logician was acquired by GE Healthcare. Logician is now known as Centricity® EMR.
In December 2002, Millbrook Corporation was acquired by GE Healthcare. Millbrook Practice Manager is now known as Centricity® Practice Management.

Dr. Neil Rawlins sees the future of healthcare in artificial intelligence that will instantly calculate trends, analyze data, and eliminate clerical tasks that now consume much of a doctor’s day. Now he’s doing his part to make that prediction a reality at Associated Physicians for Women. This practice has created an information system that integrates Centricity EMR with Centricity Practice Management 2002, making it easy for providers and staff to get the information they need, instantly, anywhere.

The human touch will always be critical to healthcare, but there are things a computer can do better and easier than a physician: search patient rolls for a list of everyone taking a recalled drug, for example. Instantly calculate current outcomes for several treatment alternatives. Or analyze a combination of treatments for possible interactions.

That decision-making support was part of the reason the partners at Associated Physicians for Women wanted to expand their computer system. They had been using Centricity Practice Management since 2000 and were very pleased with the increased efficiency it brought to billing and administrative tasks.

As the practice grew – more than doubling in just three years – it became more important to improve the efficiency of clinical operations as well. The physicians were staying late every night to complete charts. It took four full-time clerks just to keep up with the filing. And with HIPAA regulations about to require the practice to log every chart access, it seemed clear that the time had come to expand the computer system.

Wireless network integrates clinical, billing information

APW had been using Centricity Practice Management for several years, and didn’t want to change that software. Because Centricity Practice Management is built on Microsoft® Windows® and the HL7 standard, that requirement still left this practice with dozens of choices in EMRs.

"We evaluated a lot of different EMR systems, and felt that GE provided the best solution," explains Vern Turney, APW’s practice administrator. "We liked Centricity EMR for its ease of use and the stability of the company." In addition, APW talked with several other obstetrics and gynecology practices who use Centricity EMR, and who were all very impressed with it.

The resulting information system was installed in August 2002, followed by several months of training provided by Healthco Information Systems, the practice’s value-added reseller (VAR). They began using the full system in February 2003. 

APW’s network includes nine servers. Three database servers manage the primary applications: one running Centricity Practice Management, one running Centricity EMR, and a data transaction server that uses the Centricity Integration Kit, Centricity EMR Link, and Rosetta Stone.

The Microsoft Windows 2000 system also includes terminal servers for Citrix thin clients and remote access, an Exchange server, a dedicated backup server, and a document management server that stores images attached to Centricity EMR.

Hardware includes a mix of Citrix thin-client terminals, laptops, and Fujitsu Stylistic ST4110 tablet computers running Windows XP Tablet. The office uses a wireless network, which is being expanded to the hospital across the street. There’s also a fiberoptic cable to the hospital and remote dial-up access for the physicians.

This practice’s 11 providers carry the Fujitsu tablets as their primary computers, replacing the desktop, laptop, and PDA. The tablet computers allow doctors to use either handwriting recognition or a keyboard to enter data. Because they operate on the wireless network, the tablets can pull up the information the doctors need from anywhere in the office, in the exam room or as they walk down the hall.

Turney points out, "It’s a huge paradigm shift to computerize, and we found that the tablet PC was an incentive. It’s a fun toy – the providers were intrigued and they wanted to use it. Then,once they got started in the system, they liked what it could do for them and the tablet became secondary."

Combined systems reduce the workload

Integration between Centricity Practice Management and Centricity EMR eliminates much of the data entry associated with setting up a new patient chart. When a woman calls for an appointment, the front desk takes all her demographic and insurance information down in Centricity Practice Management. Then Centricity Practice Management automatically exports that data to Centricity EMR, which uses it to create the new chart.

Computer stations throughout the office provide instant communication. For example, if a patient misses an appointment, when it’s rescheduled at the front desk the change shows up instantly at the nurses’ station.

Centricity Practice Management automates many administrative processes, from scheduling to printing HCFA forms to electronic claims submission. As more and more payers require electronic claims, that aspect has become particularly critical. Turney says, "Most of our claims go electronically these days. And most of them are paid within three weeks."

Better information, better patient care

Clinical procedures have changed with Centricity EMR, too. The nurses have laptop stations outside the exam rooms. In addition, every exam room has a Citrix thin-client terminal. The nurse takes a patient in, logs into the terminal, and enters data as she completes the initial health interview. The nurse then logs out before leaving the room to provide data security.

When providers see patients, they can use either the in-room terminal, their personal tablet PC, or a laptop station. Instead of taping dictation and hiring a transcriptionist, or staying for hours after the office closes to write up chart notes, the providers can select menu options or enter observations on the fly.

That flexibility is where the tablet PCs and wireless network really shine. The providers carry those tablets with them all the time, as their primary computer. Each doctor has a docking station, some with flat-panel monitors. The physicians can then do their charting in Centricity EMR, check an appointment schedule in Centricity Practice Management, or just find a patient’s phone number.

Turney says, "The most exciting part of this system is the mobility it allows our doctors. They can access all the information they need from home, and soon we hope to expand our wireless access to the hospital across the street. When we finish that, our doctors will be able to walk out our door and into the hospital, and have the same connectivity there that they do in our office."

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"As the practice manager, I really like Centricity Practice Management’s ability to show me everyone’s schedule at once. The visual impact is important – I can tell immediately who’s where and how resources are being utilized."

Vern Turney,
Practice Administrator, Associated Physicians for Women, PLLC
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APW is phasing out paper charts gradually, as patients cycle through for their annual exams. There will always be some paper, though, such as consent forms for certain procedures orlaparoscopic pictures that are too big to scan and view over the wireless network. But the goal is to be as electronic as possible within a year.

Even while paper is being phased out, this practice has seen a significant reduction in the amount of filing and other clerical work. They’ve gone from four records clerks to three, a 25% reduction. And the system has even reduced the workload for labor and delivery nurses in the hospital across the street.

Turney explains, "Before we had Centricity EMR, the labor and delivery nurses had to call the office and have the medical record faxed to them, then manually enter it into their computer system. Sometimes, after office hours or on weekends, our doctor on call even had to walk across the street and copy the record to bring back. With Centricity EMR, we’ve created a custom report that gives those nurses exactly the information they need. Now they can dial up, enter a password that gives them limited access, and print out a 2-page report with all the information they need. It’s streamlined the process tremendously, especially in the middle of the night."

With Centricity Practice Management speeding up administrative tasks, and Centricity EMR improving the clinical charting, APW can handle its explosive growth while improving patient care and its financial health.

Benefits

Centricity Practice Management, Centricity EMR, and a wireless network give APW’s healthcare providers and administrative staff instant access to the information they need. For more than three years, Centricity Practice Management has been helping this practice reduce its administrative costs and improve cash flow; now Centricity Practice Management and Centricity EMR are working together to eliminate work for the whole office. Just a few months after adding Centricity EMR, APW was able to reduce its records staff by 25% with no loss of productivity. The physicians can go home earlier instead of spending hours completing paper charts. Patient information is now available to providers when and where they need it, whether it’s a 2 a.m. call at home or a Sunday morning delivery at the hospital.

 

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GE Healthcare
540 W. Northwest Highway
Barrington, IL 60010
U.S.A.
www.gehealthcare.com

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