Reliant Medical Center – Electronic Medical Record Patient Flow

Gene Howell, CEO, Reliant Medical Center shares how Agility (Occupational Medicine EMR) helped them rethink their processes and made drastic improvements.

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Gene Howell:  Soon after installing Agility  we really need to look at the process and really rethink the way we do things within the clinic. You know going from a paper chart environment to an EMR, I think, initially people have this idea that it’s paperless and you know we really made a sort of hybrid environment if you will.

When the patient arrives we give them a questionnaire to complete. This questionnaire matches the Agility system exactly, so we capture the PMH and the review systems up front, while the insurance is been checked in the back.

When the patient is brought into, what we call an intake room, they capture the HPI and review the questionnaire for inconsistencies or concerns. For example, if someone has indicated they have hypertension but we don’t see that there’s any meds listed it may be a question that we asked to verify is this in fact correct, or have you missed something? Really, its a chance to make sure the information is correct, the history is correct and also it gives the patient a one-on-one for a few moments at the start of the process so they feel they’ve had that attention.

The patient is then brought into a room. We check Agility to make sure there’s a room available and walk the patient back. That same medical assistant, LVN or RN, takes the vitals and preps the patient for the provider.

So by the time the provider enters the room we have completed about 30 percent of the charting process. We’ve completed the entire history up front and they’re ready for the exam.

By using the workflow we’ve designed in the questionnaire capturing the history up front we feel that we’ve solved two issues: that’s giving the provider complete history before they enter the room, and really allowing the provider to enter at a point which they can really just begin the exam after reviewing these items limiting the amount of time that they’re having to spend in the system, and entering those items that an MA, an LVL, or RN could enter.

So the EMR and the process itself in the workflow has allowed us to consolidate and compartmentalize the portion that the staff is taken care of and then the providers taken care of.

The provider then sees the patient. Our providers have chosen not to chart within the rooms although we initially equipped the rooms for that, they felt that they were more effective to leave the room, go to a charting station or their office to do the charting, and place any orders, results, etc.