EncounterPRO's CONNECT, COMMUNICATE, AND COORDINATE VISION
The page is about vision. Should you want us as your partner for the next five to ten years? Where is health information management going and what are we doing to take us, and you, there?
The simple capacity to connect and communicate data is insufficient. You need to connect, communicate, and coordinate. As successful examples of clinical groupware, EMR workflow systems are all about care coordination. Workflow engines execute process definitions in order to coordinate the accomplishment of tasks. The EncounterPRO Health Information Exchange (EPHIE) has two tasks, to transport and to translate clinical messages, be they immunization data, lab results, e-prescriptions, or demographic and billing data. EncounterPRO's workflow engine and EPHIE's interface engine work together like a hand and glove to automatically, quickly, efficiently, effectively, reliably, and flexibly communicate the right clinical data to the right person at the right time and place. It's what makes clinical groupware so great. It's why our tag line is "Clinical Groupware for Pediatric Practice."
Our mantra is that whatever EMR feature or functionality concerns you most, it's accomplished better in a clinical groupware solution such as the EncounterPRO Pediatric EMR Workflow System. It is more efficient, timely, safe, effective, patient centered, and equitable.
Consider electronic results management and interfaces to state immunization registries. (For details on e-prescribing, practice management systems options, and popular medical devices please be referred to their respective pages and subsections on this website.)
Electronic Lab Result Management Workflow
Consider the lowly electronic lab result. It was one of the first clinical data routinely exchanged with ambulatory EMRs. Pediatric practices with electronic connectivity to clinical laboratories *still* suffer from the following problems (Ferris et al. Electronic Results Management in Pediatric Ambulatory Care: Qualitative Assessment, PEDIATRICS Vol. 123 Supplement January 2009, pp. S85-S91):
- Increased costs due to redundant tests
- Decreased efficiency
- Insufficient pediatric-specific customizations
- Duplication of workflow (electronic *plus* paper)
- Lost orders
- Failed follow-up management, resulting in
- Missed or delayed diagnoses and
- Delays in follow-up test ordering
The last three problems are particularly sobering since a substantial percentage of malpractice claims are due to failures in these areas. All of these problems are especially acute in solo and small practices with limited resources (for which the EncounterPRO Pediatric Workflow System is perfect. All three of the first HIMSS Davies Awards went to solo practitioners using the EncounterPRO EMR Workflow System—two pediatricians and one physician with a combined obstetrics, gynecology, and family medicine practice).
Compared to a traditional pediatric "singleware" EMR, a clinical groupware workflow system flexibly but reliably implements closed loop test monitoring (every test result is tracked to its final disposition). As a direct result electronic laboratory result management is more efficient, timely, safe, effective, patient centered, and equitable.
| More Efficient |
Less staff time tracking results, answering calls for lost results, and performance of redundant tests. |
| More Timely |
Automatically, tests results are inserted into the right patient's chart and To-Do items added to the right staff members To-Do list.
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| Safer |
Less delay or risk of lost results leads to more rapid and certain transmission of abnormal results to patients. |
| More Effective |
More complete chart, more consistent workflows and To-Do item generation lead to improved access to results and adherence to guidelines. |
| More Patient Centered |
Improved communication from provider to patient leads to decreased delays in patient notification. |
| More Equitable |
Standardized automatically executed workflows rather than reliance on individual providers make sure all patients have equal access to test results. |
A similar sort of analysis could be performed with respect to any incoming clinical data. Without a workflow engine and process definitions to automatically but flexibly close the loop, practices will only incompletely leave paper behind, and will continue to endure slow, redundant, inconsistent, and ultimately ineffective workflows (traditional "singleware" EMR problems), resulting in less than optimal clinical performance, patient and provider satisfaction, and practice profitability.
State Immunization Registry Workflow
To paraphrase KFC, we do state immunization registries right. In fact we have spoken at both the HIMSS and the Public Health Information Conferences about the proper way to build interfaces to state immunization registries.
What's our point? We know enough about what works and what doesn't work when interfacing to state immunization registries that we give national presentations in which we actually grade the various state immunization registries for how well *they* implement pediatric EMR friendly interfaces.
OK. We have another point. And it is the same point that we made previously with respect to electronic lab result management (and to e-prescribing). Whatever pediatric EMR functionality you think is important, whether it is internal to your practice, or requires hooks to an external clinical partner, it's better on a clinical groupware workflow system, such as the EncounterPRO Pediatric EMR Workflow System.
State immunization registries want five things from EMR vendors, two of which are excellent workflow, so as to not impede physician productivity, and automated upload of immunization data. In partnership with the EncounterPRO Health Information Exchange, the EncounterPRO Pediatric EMR Workflow System does both.
THE NEXT FIVE YEARS:
THE EHR NETWORK EFFECT
OK. Again. What's our point?
Our point is that when you look at whether or not an EMR has electronic lab results, has e-prescribing, has uploads to state immunization registries, and so on, be sure to consider the whole that is greater than the parts. The same technology used to transport and translate this clinical data into and out of your EMR will also be used to move many other kinds of data in the future, including: biosurveillance, population management, and process benchmarking. Make sure that your EMR vendor has a vision of what the next five or ten years is going to look like and has a plan to make sure that your future data will arrive as automatically, quickly, efficiently, effectively, reliably, and flexibly as your current data.
SureScripts E-PRESCRIBING WORKFLOW
The EncounterPRO Pediatric EMR Workflow System's implementation of our direct interface to the SureScripts Electronic Prescribing Network is so good, we've devoted an entire page on this web site to it.
PRACTICE MANAGEMENT WORKFLOW
Ditto.
MEDICAL DEVICES
Please see our pediatric-specific functionality page.
Children's artwork courtesy of A Child's Night Out.
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| TESTIMONIALS |
"Waiting times have been dramatically reduced every step of the way—not just the waiting room time. Parents are happier because going to the doctor no longer takes two hours out of their already overcrowded schedule. I can see more kids per hour with an actual increase in preventive services like screenings and vaccines—thus improving healthcare and increasing revenue at the same time." Jeffrey D. Cooper MD Pediatrician EncounterPRO User Since 1995 (and HIMSS Davies Award Winner)
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"It has allowed our physicians to increase the number of patients they see in a day...And it has given the physicians that were already high-volume the opportunity to spend a little more time with their patients and be more personable." Dee McGee, Pediatric Practice Manager EncounterPRO User Since 1995
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"It's really helped my lifestyle. I'm working three and a half days a week, I used to work seven days a week. So it's really made life much easier, and the staff love it!" Armand Gonzalzles MD Pediatrician EncounterPRO User Since 1999 (and HIMSS Davies Award Winner)
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"At a time when physicians are being squeezed by cost constraints of record proportions while trying to continue to provide quality care, it is absolutely imperative that you look for a system that delivers security, cost efficiencies, and unparalleled quality of care in a new way—EncounterPro is that system." John Ivan Sutter MD Pediatrician EncounterPRO User Since 2000
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"One Monday in the winter we had only two of our five doctors in the office. Then my partner was stuck at the hospital and I was left by myself. At the end of a long day I had seen 79 patients! I wasn’t even frazzled." Karen Kamachi MD Pediatrician, EncounterPRO User Since 2000
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"My office went live 2 days ago and it's unbelievable! For the first time in my nearly 15 years in pediatric practice I left my office with all my charts and notations completed for the day...Thank you so much for giving me a life again!" Angela D. Hunt MD Pediatrician EncounterPRO User Since 2001
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"When I selected EncounterPRO, the biggest motivating factor was the concept of having an office screen that displays the necessary patient activities. This is similar to the ER board that many of us are familiar with that lists where each patient is and what procedure needs to be done next. In a procedure-oriented practice like ophthalmology, the efficiency from this tool is tremendous. The idea of telling staff what to do silently without disruption took me over the top. Features like this can eliminate the need for signaling lights or flags on exam room doors. The final big feature is workflow. Essentially, the program automatically sequences through your documentation depending upon the type of exam you have chosen." Phelgar Washington MD Ophthalmology EncounterPRO User Since 2001
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"The EMR user interface is akin to the touch screen-oriented systems in restaurants: one screen at a time, with only the most relevant data displayed and options presented (although, of course, a user can always jump out of a particular screen sequence to accomplish an arbitrary task), and the sequences can be tweaked through the workflow management to make such occurrences infrequent...The workflow plans are tailored for each type of patient seen in the office (obstetrics, gynecologic, annual exams, family practice) assuring that key elements of the present illness, history and physical are addressed and documented. Work plans contain required laboratory tests for specific conditions, assuring that key tests are not forgotten." Jeffrey Harris MD Obstetrics Gynecology and Family Practice EncounterPRO User Since 2003 (and HIMSS Davies Award Winner)
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"Benefits I have noticed personally included: decreased turnaround time for telephone messages, decreased turnaround time for prescription refills, decreased turnaround time for referrals, improved efficiency of office procedures such as immunizations and tests, decreased time spent at the end of the day returning phone calls, writing refills, and completing charts." William Long MD Pediatrician EncounterPRO User Since 2004
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"Many pediatricians operate with narrow profit margins. Reducing costs, capturing charges correctly, and increasing the number of encounters can increase profit. If a pediatrician cannot chart a routine otitis media encounter from start to finish in 30 seconds, the EHR will slow him or her down and reduce profit. The EncounterPRO EHR’s workflow engine essentially pushes tasks to users as fast as they can accomplish them. However, pediatric offices accomplish tasks in many different orders, so the workflow definitions can be changed to accommodate a specific pediatric group preference." Michael Blum, DO, Pediatrician EncounterPRO User Since 2004
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"EncounterPRO has made our workflow very smooth. We see 30-40 patients daily and we are almost always finished with all work by 4:30 in the afternoon. No need to stay late and file charts." Stephen Dentler MD Pediatrician EncounterPRO User Since 2004
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"In the height of the physical season, from the minute the patient walks in the door for a kindergarten physical, gets all the preliminary screening test (vision, hearing OAE VEP), heights, weights, BP plotting, physical exam blood work and immunizations, we are getting folks out the door in under an hour and that is decreasing. This is unheard of." George Rogu MD Pediatrician, EncounterPRO User Since 2008
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"EncounterPro's simplicity and design distinguishes it from the competition. It is a workflow-based system. An office equipped with EncounterPro has a computer terminal in every exam room. At any of these terminals, you can find out what is going on in any room, if a room needs cleaning or setting up for a new patient, if a patient is waiting for vital signs to be taken or a nursing assessment to be done, or if a physician is interviewing or examining a patient. EncounterPro features a very simple interface, with large, clearly marked buttons and interchangeable screens. You can switch from nursing-intake screens, to vital-signs screens, to prescription and super-bill generating screens. From any screen, you can create a comprehensive office note from a series of lists. EncounterPro has received many awards for design." Contemporary Pediatrics 2001
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"It was very easy to use, and was built around a pick list-type structure for creating encounters. It has a clean interface and is built so that you can enter data by touching the screen with your finger - large decision boxes, etc. The thing I noticed was that even the least computer-sophisticated doctors in the demo group sat right down at the screen and started tapping away with no fear." Stamford IPA Review of Office Medical Systems 2000
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E-Prescribing
