Northwest Montana Surgical Associates

Case Study

April 2013

Northwest Montana Surgical Associates is one of several medical practices in northwest Montana affiliated with Kalispell Regional Healthcare and Kalispell Regional Medical Center.  The practice works in conjunction with the hospital to provide area residents with access to quality surgical services close to home.  Northwest Montana Surgical Associates has two offices with seven full-time surgeons.

Kalispell Regional Medical Center in Kalispell, Montana

Kalispell Regional Medical Center in Kalispell, Montana

More than a year ago, Northwest Montana Surgical Associates made a decision to add real-time speech recognition software to its eClinicalWorks electronic health record (EHR) and practice management solution to improve clinical work flow and communication with referring physicians while enhancing patient care.  The practice chose Dragon Medical speech recognition technology, designed to help physicians navigate and dictate the narrative portions of the note directly into a patient’s electronic record.

Several months after the initial implementation of eClinicalWorks, utilization of the EHR and dictation software were well below expectations.  According to Kelly Gallipeau, Practice Manager, three of seven physicians were dictating their patient notes to an outside transcription company, which transcribed them into paper-based progress notes that were electronically faxed, printed and then scanned into the EHR as patient documents.    These physicians, then, transitioned to using the hospital transcription department to transcribe their notes into electronic progress notes.  “The department’s limited knowledge of eClinicalWorks and the in-office progress note process made this a logistically challenging and expensive option for our practice,” said Gallipeau.  

Instead they were typing and templating in eClinicalWorks, which they viewed as cumbersome and not specific to general, vascular and thoracic surgery specialties.  The mixed-bag approach to eClinicalWorks and Dragon Medical resulted in an inconsistent process for capturing and recording in-office progress notes.

Northwest Montana Surgical Associates had two of the best tools in the business for clinical documentation.  So what went wrong? While most EHRs promise significant improvement in productivity, profitability and patient care by automating routine processes, after a year or more, physicians are spending more time than ever at the office and productivity gains haven't materialized.  Given unlimited amounts of time, physicians could certainly read the documentation, customize the system and incorporate their workflows to achieve all that’s promised with EHR and voice-recognition software. However, most physicians would rather be seeing patients.

Logan Solutions’ knowledge of Meaningful Use requirements and changes necessary in workflows was important and timely
— Kelly Gallipeau, Practice Manger

That’s why Logan Solutions combines clinical experience with an understanding of technology to offer optimization and training services designed to help practices get the most from their EHR. Logan Solutions’ clinicians started working with Northwest Montana Surgical Associates by developing a thorough understanding of the practice environment including hardware, network reliability, current workflow, and each physician’s comfort level with technology. Then, together with the medical team, Logan Solutions developed a plan that included software customization, workflow redesign, process improvement and retraining of the physicians and staff.

“Paul Logan’s professional experience as a nurse practitioner with prior experience in an OR enabled him to speak the language and develop a good rapport with the surgeons.” Gallipeau said.  “Logan Solutions knowledge of Meaningful Use requirements and changes necessary in workflows was important and timely,” she added.

Roch Boyer, M.D., F.A.C.S.

Roch Boyer, M.D., F.A.C.S.

Within three weeks of working with Logan Solutions, Northwest Montana Surgical Associates achieved 100% utilization, with every physician using Dragon and all 15 staff members involved in eClinicalWorks. The quick and exceptional results are attributed to the thoroughness and customization of the optimization process. “Before Logan Solutions’ assistance, the members of our surgical practice used eClinicalWorks and its EMR inconsistently,” said Dr. Roch R. Boyer, MD, F.A.C.S.   “Getting help from an expert and a clinician resulted in more consistent and efficient use of the EMR.  In addition, combining Dragon Medical with eClinicalWorks improved workflows and overall utilization of the EMR software,” he said.

The practice started to experience the results it hoped for when it purchased eClinicalWorks and Dragon Medical.  “Finally, we had a more efficient process for progress notes that resulted in improved patient flow,” said Gallipeau.  Several sections of the patient notes are entered by the Medical Assistant, which frees the surgeon to focus on three sections: HPI, Exam and Assessment.  The surgeons dictate these sections using Dragon Medical. The improved work flow also means that progress notes are sent to the referring physicians in a more timely and streamlined manner.

Northwest Montana Surgical Associates also experienced a much-needed cost benefit.  The practice was able to transition from it’s reliance on hospital transcription, which was impacting the profitability of the practice.  “Practice profitability goals could no longer support continued use of hospital transcription,” said Gallipeau.  “Logan Solutions more than paid for itself in transcription savings,” she said.

Based on Northwest Montana Surgical Associates’ experience and results, other practices within Kalispell Regional Healthcare turned to Logan Solutions to enhance the benefits of their EHR’s.  For more information on how Logan Solutions can help your practice achieve 100% EHR utilization, contact Logan Solutions today.