Electronic Health Records


Physician series: Beyond meaningful use with Winfield Young, MD

By Kyle Murphy, PhD

- With the deadline for eligible professionals (EPs) to receive maximum incentives in the Centers for Medicare & Medicaid Services (CMS) Electronic Health Record (EHR) Incentive Programs less than a month away, the pressure is on providers to adopt and implement EHR systems quickly. But choosing the wrong vendor or the wrong system could prove costly in the years to come beyond meaningful use.  “We tend to think that the more we pay for a system, the better it is. However, in terms of computers and EHR, that’s not the truth,” observes Winfield Young, MD.

Dr. Young serves as the director of Pediatrics of Kempsville (Virginia Beach, VA), a medium-sized practice that specializes in pediatrics. For Dr. Young and his colleagues, the decision to transition from a paper-based system to electronic records wasn’t motivated by the allure of meaningful use. Instead, their recent decision to adopt an EHR system was based on a need to keep with the times, both in terms of efficiency in their business as well as convenience for their young patients and parents. As early late September, Pediatrics of Kempsville will roll out Hello Health, the cloud-based EHR provider.

In this latest edition of our Physician Series, we caught up with Dr. Young who explains that EHR implementation is about much more than meaningful use as well as the value of a free cloud-based EHR system.

What has been your experience using an EHR?

This is a little different in the sense that this is the first EHR that we’re getting. Notice the word getting. As the director of the group, I have hesitated to adopt an EHR for many reasons: the cost, the downtime that we hear of, the poor training. As a result, what we see reflected is that a lot of doctor’s offices are on their second or third EHR, and we wanted to avoid those traps.

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Why did you select your EHR vendor?

There isn’t anything wrong with our paper chart system. There isn’t a perfect system. But finally after looking at all the different EHRs, I liked that Hello Health said they will give up to ten weeks of training — sort of stating that their goal is to get us on track rather than just selling us a system and then leaving. In that regard, it’s not so much selling a system because the system is actually free to us. But there is a kind of investment on their side to have us established with an effective, going system. That the patients are going to participate, there’s a financial reward for Hello Health.  So it is to their advantage to get it into offices that they evaluate to be cost-effective to [the vendor].

How prepared were you to move to electronic records?

We were always computerized, even on a DOS-based practice management system. That was not connected to the internet, it was intra-office. It didn’t have office notes in it, but it had billing. Then we went with a billing service that was on the internet. In one sense, we had the infrastructure up (network, computers), so to go with an online system was very easy. I would advise anyone not to go with DSL but cable. In terms of wireless, we’ve been changing between the different manufacturers of routers. Thank God, the prices are inexpensive. Actually, choosing a web-based system for a doctor’s office — if you’re not dealing with multiple offices but a single office — is quite easy. We’re using laptops, but basically for the convenience of the provider. The rest of the computers are PCs for the staff. It’s an easy transition. We hope to go with tablets, which will be easy to carry into the rooms.

Why did you choose a cloud-based EHR solution?

The application was little long, but it gave us time to see what they meant by the cloud. Here we have other EMRs advertising the cloud: They use that term, but sometimes the consumer (even the physician as a consumer) doesn’t know its true definition. But when we talk about a patient being able to make an appointment through the patient portal while we’re also making an appointment for another patient, we’re realizing that the cloud will ensure that my staff won’t be double-booking for that time.

Did you have any reservations about the cloud?

I would have reservations just like anybody else, and then comes the issue of backup: knowing that they do backup and are secure and HIPAA-compliant. I thought about how I would be able to get my information if I needed to, and they said, “You can always download it in a PDF file.” They’re using a PDF file rather than a proprietary language.

Were you concerned about the level of patient access?

Some software vendors say that patients can have their charts. I thought about that. How secure is that? When looking at Hello Health, the physician actually has control over what patient will see through the patient portal. People wouldn’t be able to hack in; they’re actually not seeing your entire chart. Patients see what you want them to see. In pediatrics, parents like to see the growth curve, immunization record, and last checkup for height and weight. In that sense, we can let them see that, but we actually have control.

Will you attest for meaningful use?

We hope to, we started the application. For us, we hope to get it, but it’s not big concern of ours. You should not look to that stimulus bonus to offset the cost of your EMR because it won’t. The gossip from the physicians would be, “It’s not so much the cost of the EMR — I got one for fifteen thousand, twenty thousand — but the maintenance fees.” You can expect an average of twelve hundred to sixteen hundred dollars a month. And that’s forever.

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