How did the program change patient care?

It did help to make me more aware of a few things. The [CDSS alerts] put me a little bit more on a routine to ask those questions. For example, I’m a physiatrist so I do see patients who are seniors. [The program] made us a little bit more alert to add on to what we were doing. If a patient had a fall, then we were going a step further to see what we can do for this patient from a rehab point of view or to see if there could be any problems in the future. We were making sure that we are documenting, even if a patient has a previous [issue] or if it’s old. We were adding on to make sure we reach that other criteria. Sometimes with this busy lifestyle you can forget, and this put us on more of a routine to ask those questions. Those kinds of things were helpful. 

Did your patients notice a difference?

I think the patients were happy that we are really thinking about more things that are good for them. If a patient comes to me with the one issue, let’s say a shoulder problem, we really look at the whole picture: what is a function level, what is the sleep level, all those things because that really helps the patient in the long term. The patient portal was hard, but the patient education [in the patient portal] was very, very, helpful. It was so much information. It was an added benefit to the patients.

Did it improve care quality?

I must say that it has improved some quality care, because we used the quality measures. [eClinicalWorks] did pick up some good features like on BMI, smoking, falls, and medicines. Sometimes when you’re doing the paper charts, especially in my field, it is important but not that important that I need to know each and every medicine. But now we’re into that habit of collecting all that information. That helps take the decision-making out of it.

Most of the [quality measures] got really useful and helpful. For example, pain management, fall prevention, osteoporosis. We were made aware of those things. So that did help me.

What feature in your EHR is the most useful?

E-prescribing, medication reconciliation is very good. I love it. Those kinds of things are very beneficial. Partly it’s the program and partly it’s the EHR.

Was it worth the challenges?

I will definitely say it is worth going all the way. Naturally, money’s always an incentive. But I think it also improves the quality care. It makes you aware of a lot of those small things, and physicians are very busy. Especially PCPs. I don’t have a patient load like they do. I think it’s very useful for them.

Part of this was training for the staff in a way too. Everyone had to pitch in and make sure this was done well. Now the staff is taking a lot of information, which is really important to meet that criteria. The staff is taking all the medicines. They’re asking the questions about the falls. They’re asking questions about smoking. Those kinds of things are very important if they’re all done before the patient comes to see the doctor. Then the doctor can go over and review with the patient. It’s much easier and more effective.

The security risk assessment was actually very good too. We found our server was very difficult to maintain for security and had to do backups. Then we changed servers. That was a very good part of the program.

Now that Dr. Gupta has completed the NY Medicaid EHR Incentive Program, the practice is exploring how to use their EHR to improve preventive care and plan for future practice needs. Dr. Gupta’s daughter and IT expert, Zeena, explained, “We can run reports and ask questions, for example, are we seeing a lot of shoulder cases? That can help to dictate some of the equipment we’re getting in the office.”