In 2009, when a handful of practices signed on to become the first users of PCC EHR, East Bay Pediatrics
took notice but decided it was too early to jump into the fray.
The practice in Berkeley, CA, had been a user of PCC's Partner practice management system for 20 years and knew it would one day purchase the Winooski, VT, company's pediatric-specific EHR, but a technology pioneer it was not, says East Bay partner Dr. Rick Oken. “I know some practices think it's nice to be first out of the box, to test drive and help innovate new technology, but I'm a bottom line guy,” Dr. Oken says. “I wanted the EHR at least to be out of kindergarten, and now it is, and we made the right decision.”
PCC EHR was introduced in 2009 as a basic system comprised of growth charts, a schedule and basic charting capabilities. The pediatric-focused EHR has since matured into a very customizable system that features charting, electronic prescribing, superbill, scheduling capabilities and templates that can be configured to the user's preferences. New features are released monthly and are designed, in part, on feedback and requests from PCC EHR users.
East Bay Pediatrics has been online with the now-seasoned PCC EHR for six months and its clinicians have become ardent fans. Since using PCC EHR, the practice has experienced increased revenue through improved coding and charge-entry accuracy despite a lower patient volume brought on by the high cost of insurance. The boost in income, as well as an increase in clinician productivity at the nine-doctor practice, is directly tied to efficiencies within the system, says Dr. Oken. “Productivity went up 10 percent when we went online with the EHR and our cash flow in the last quarter of 2011 went up 8 percent,” he says. “We're big proponents of PCC EHR.”
In the last sixth months with PCC EHR, East Bay Pediatrics has increased its Evaluation and Management (E/M) coding revenue substantially. The comprehensive clinical guidance within the structure of PCC EHR has ensured against under-coding on complex visits, says Dr. Oken, resulting in a 16.5 percent practice-wide increase in the number of 99214 visits during the same six-month period in 2011. “We've not only increased coding, it's legitimized and documented through the EHR,” Dr. Oken said.
PCC's Chip Hart did a brief analysis of the practice and concluded that the numbers added up. “Even with a lower visit volume due to payer negotiations and a reduced flu season, the practice is generating substantially more revenue than they did during the same time frame last year,” Hart says. “The practice more than paid for the EHR with these coding improvements and didn't face what many practices face: Having revenue problems as a result of productivity challenges with a new EHR. To be honest, I'm really impressed with their results.”
East Bay Pediatrics has also staved off the bleeding in vaccine revenue loss. Before going online with PCC EHR, says Dr. Oken, East Bay Pediatrics was missing out on $50,000 a year in potential vaccine charges that were falling through the cracks at its multiple locations. Now, clinicians who administer a shot may immediately send the order, with the correct procedure code, to the electronic encounter form with a click of a button. “We spend $100,000 per doctor, annually, on immunizations, and we were spending five percent of our time essentially giving away $50,000 a year,” says Dr. Oken. “Now, when I order a shot and the nurse gives it, it automatically enters into the billing sheet. Buying PCC EHR was the best decision we've made in the last five years.”
In the long term, use of PCC EHR will also create savings in paper-chart-related costs, says Dr. Oken. Since implementing the EHR in mid-September, the practice has been methodically scanning its patient charts, which number about 17,000 and accrue off-site storage costs.
PCC EHR's pediatric focus, its integration with PCC's Partner practice management system and minimal (less than $3,000 per doctor) start-up cost drove the sale, but the clinical performance and out-of-the-gate financial results to date have proven East Bay Pediatrics made the right decision, says Dr. Oken. “If PCC EHR was in the Letterman Top 10 strategies for economic survival, it would be number one on my list.”