Dermatology EHR and practice management tech improves care, MIPS performance
Windsor Dermatology in East Windsor, New Jersey, was looking for a new electronic health record system, but staff knew they needed more than just a typical EHR.
Staff believed the practice needed an EHR that "understood" it was focused on dermatology.
"Meaningful use was looming," said Sunny Holman, practice manager at Windsor Dermatology. "We desperately needed one-system harmony to reduce costs, user errors and employee stress."
Windsor decided on a dermatology-specific EHR system called EMA from Modernizing Medicine, along with the vendor’s dermatology-specific practice management system and analytics platform that integrate with EMA in what is dubbed the modmed Dermatology suite.
"Before the switch to EMA, we had 30 years’ worth of paper charts – there were endless copies and paper everywhere," Holman said. "We were always trying to find a missing chart for the next day, and routine audits and medical record requests were arduous."
Additionally, only one person could work on a chart at a time, which meant, for example, that both billing and nursing couldn’t work in tandem on a patient’s records. So staff was constantly following a trail of super-bills or missing super-bills and they were always days behind in posting and days behind in getting paid. Windsor could not see how to meet meaningful use without an EHR.
"EMA is dermatology-specific, and it feels like it’s made just for our practice," said Holman. "It’s created in part by a dermatologist, Dr. Michael Sherling, who currently uses it in his practice. You can’t get a better user experience than one that comes straight from the dermatologist who uses the software in his own practice."
There are not many vendors on the market that specialize solely on EHRs for dermatology practices. But there are many vendors that offer integrated EHR and practice management systems for group practices, including AdvancedMD, CareCloud, Centricity, DrChrono, eClinicalWorks, Harmony, Kareo and PrognoCIS.
MEETING THE CHALLENGE
One aspect that Windsor likes most about EMA is that it is smart in the sense that it learns user preferences. The medical assistants scribe in what staff describe as "a user-friendly system" and native iOS app on an iPad, and the dermatology EHR system automatically creates the bill.
"Because EMA integrates with practice management, our scheduling, check-in, checkout, billing and reporting are streamlined," Holman said.
"For example, once the visits are finalized, they are billed automatically and we no longer have to post super-bills, which reduced errors and enabled us to remove a position in the billing department. The days of missing super-bills are gone. The days of user error in posting the super-bills are gone."
"We not only achieved the minimum score for all our providers last year, but we also achieved the incentive bonus for all providers, which we're very proud of."
Sunny Holman, Windsor Dermatology
Windsor also is quite happy with the analytics functionality. Staff say analytics makes the dermatology-specific EHR the ultimate system for its needs. EMA automatically creates reports for tracking productivity, demographics, Merit-Based Incentive Payment System and more.
"Practicing dermatologists actually build the software, so the difference between EMA and other EHR systems is the specialty experience it offers and the commitment the vendor makes to investing in its dermatology EHR with continuous improvements," Holman said.
"Our front office, back office, medical support staff and physicians all use EMA and the practice management system," she explained. "Some of our practitioners use the iPad and some use the PC, and we’ve found that both are user-friendly."
The Healthcare Financial Management Association’s Key Performance Indicators and Standards reference insurance accounts receivable 90 days from date of service as less than or equal to 15 percent to 20 percent. The new practice management system has operationally supported Windsor Dermatology at exceeding this standard, Holman reported.
"We have submitted claims via the practice management system since September 2016, and we currently maintain a 2.1 percent of insurance accounts receivable 90 days from date of service," she explained. "My billing staff work hand-in-hand with EMA and the practice management system, and because of EMA we reduced our billing staff from four to three individuals, which helped decrease costs."
Windsor also added one provider, which helped increase revenue.
"We’ve saved a tremendous amount of time and money in claims scrubbing with EMA; the custom claims scrubbing has helped keep the accounts receivable down as we no longer submit with errors, miss referrals, etc.," Holman said. "The reporting helps my billing team drill down easily to work claims as well as help look for trends that need to be addressed."
The seamless claims creation and submission has sped up the process so much that staff can work claims more quickly and identify issues before the bills fall into the next bucket, she explained. Windsor also has cut down on overhead, paper, file folder and storage costs.
Further, work with the Merit-Based Incentive Payment System is going well. Modernizing Medicine provides Windsor with a MIPS coach.
"Even though EMA does all the work, my coach helps me to understand the whole process, and she’s there every step of the way if I need it," Holman said. "We not only achieved the minimum score for all our providers last year, but we also achieved the incentive bonus for all providers, which we're very proud of."