Free EHR Proves Effective For Solo Practitioner

By Ken Congdon, Editor In Chief, Health IT Outcomes

The high cost of some EHR software makes the expense impossible for many small practices to afford. However, this independent internal medicine specialist found the functionality she needed in a free EHR platform.

If it sounds too good to be true, it probably is. And, you get what you pay for. These two adages are often used by mainstay ambulatory EHR vendors to describe some of the free EHR platforms on the market. There is a perception that a free EHR solution couldn’t possibly be as robust as one that costs several thousand dollars per license. Don’t tell that to Dr. Elizabeth Beautyman. This New York-based solo practitioner specializing in internal medicine and hematology recently put her faith in a free EHR by Hello Health. She believes the functionality of the Hello Health platform rivals that of many paid EHRs, and her practice is reaping numerous benefits as a result of using the technology.

RECORD LEGIBILITY CONCERNS PROMPT MOVE TO EHR
Unlike many practices that have adopted EHRs in order to capitalize on the Meaningful Use stimulus funds offered by the federal government, Dr. Beautyman’s motivation to make the move to EHRs was poor record legibility. “Don’t get me wrong, incentive dollars were attractive to me, but Meaningful Use wasn’t very influential in my decision to move to an EHR because I knew that I might not be able to do all of the work necessary in order to qualify,” says Dr. Beautyman. “My motivation was to have clean, legible charts. My handwriting was becoming impossible even for me to read. I used to take time writing out my charts, but ever since managed care, I’ve been writing faster and faster in order to keep up. Record legibility has suffered as a result. If I can’t read my writing, then my staff, the insurance companies, and other third parties can’t read my writing, which can lead to all kinds of problems.”

While she admits she didn’t do much shopping around, Dr. Beautyman did consider investing in the ambulatory EHR platform in use at a neighboring hospital. This EHR is one of the top ambulatory EHRs on the market, and the hospital required all of its outpatient clinics and some of its voluntary attending physicians in orthopedists to use it.

“Initially, I thought it would be nice to be on the same EHR platform as the hospital,” says Dr. Beautyman. “I thought it would make data exchange and communication with the hospital easier in the long run. However, I changed my mind once I read the reports I started getting from the attending orthopedists. I used to get nice narratives about the patient in my reports from these doctors, but after their move to the hospital’s EHR software, all I got were codes and phrases that really didn’t tell me much. It seemed like the EHR the hospital used placed too much focus on getting the coding right and not much else. I didn’t find this very valuable.”

A PATIENT-FUNDED EHR PIQUES INTEREST
Dr. Beautyman heard of Hello Health through one of the company’s salespeople, and it was unlike any EHR platform she had ever heard of. With Hello Health, she wouldn’t pay a dime for the implementation or use of the EHR. Instead, Hello Health would generate revenue through special EHR-related services Dr. Beautyman would sell to her patients.

For $10 a month, patients of physicians on the Hello Health platform can receive access to a variety of healthrelated services, including direct and secure email correspondence with their physician, online appointment scheduling, online access to their own health records, and, for an additional usage fee, online video visits with their doctor. Moreover, Hello Health shares some of the revenue generated from patients with the physician using the EHR.

The prospect of an EHR that was not only free, but also could actually generate revenue for her practice was appealing to Dr. Beautyman, but she was understandably skeptical. She requested an online demonstration of the software to ensure it could accommodate her workflow and recordkeeping needs. Overall, Dr. Beautyman was impressed by the functionality of the system.

“Hello Health gives you the ability to use either a template or free form text to populate a patient chart,” says Dr. Beautyman. “I liked this flexibility. I also thought the user interface was clean, attractive, and easy to navigate. The platform also allowed me to communicate with my staff via the software, which eliminated all the sticky notes we had floating around the office. All in all, it’s an incredibly complete EHR, and it saved me the $30,000 or more I might have had to spend on a more traditional EHR solution.

A FREE EHR PROVES ITS WORTH
Dr. Beautyman started using Hello Health’s EHR in her practice in September 2011, but the transition to EHRs didn’t happen overnight. In fact, it’s a process she’s still working through.

“Scanning old paper records into the system is cumbersome and time-consuming,” says Dr. Beautyman. “It has basically turned me into a part-time administrator. Because of how demanding the conversion process is on my time, I decided to take things slowly. I record all new patient information using the EHR. However, I’ll wait for a returning patient to schedule an appointment. At that point, I’ll go through their old paper charts and scan pertinent information into the EHR prior to their visit. I found this more palatable than mass converting all the old records on a schedule. That would have been too taxing on my time.”

Making the proper workflow adjustments has also been a learning experience for Dr. Beautyman. “I have a MacBook Air that I take into the exam room,” she says. “This allows me to look at the patient when they give me their history as opposed to turning my back to them to use a wall-mounted computer. However, I do need to let patients know that I am using EHR technology so they don’t just start volunteering information. They have to wait for me to ask specific questions because I need to ensure I am in the correct field in the EHR to enter the data. This is definitely different from what my patients and I are used to, but all in all, it’s not quite as cold and impersonal as I’ve heard other doctors complain about with their EHRs.”

While still implementing the EHR technology, Dr. Beautyman has already realized several benefits. The act of pulling and refilling paper charts has stopped. She has eliminated much of her physical record storage space. The doctor and her staff can now read what she’s recorded in a patient chart, so her employees don’t have to call her for an interpretation. E-prescribing has significantly reduced calls back and forth with the pharmacy. However, perhaps the most significant benefit is the ability to access records from anywhere at any time.

“Because Hello Health is a cloud-based platform, I can access patient records from home,” says Dr. Beautyman. “Recently, I returned home at 7 PM on a Friday night and realized that I needed to contact a patient about some test results. I went online, accessed the patient’s record, and called her from home. The patient was very impressed that I was doing all of this on a Friday night.”

To date, between 300 and 400 of Dr. Beautyman’s nearly 2,000 patients have signed up for the concierge health services offered through the Hello Health platform, and the response has been positive. “Patients like all the services, but I’ve received the most positive feedback about the direct email correspondence,” says Dr. Beautyman. “They value the direct connection to me without having to call our office and talk to one of my office staff. Plus, the fact that this communication is encrypted and automatically included as part of the patient’s record is a beautiful thing. In fact, these services are so valuable I’m thinking of making it mandatory for all my patients to sign up for them."