How an EHR Helped a Physicians Practice Manage its Sickest Patients

June 26, 2012

Treating Hepatitis C is expensive and difficult. But an EHR made it much easier to do so for a Baltimore gastroenterology practice.

Most gastroenterologists handle their fair share of patients with Hepatitis C, along with those suffering from less-severe chronic conditions. 

Unfortunately, treating the condition is expensive and difficult. As a result, an increasing number of practices - having experienced the reality that payers are often hesitant when it comes to reimbursement and authorization of the appropriate medications - are taking fewer of these patients.

But thanks to its EHR, the gastroenterology practice run by husband-and-wife physician team Jonathan Schreiber and Beverly Kelsey is not among those.

The EHR, which the couple started purchased from Amazing Charts on a trial basis more than two years ago before making a final purchase in January, allows the Baltimore practice do everything from develop protocols that have improved patient outcomes to process insurance claims in such a way that they are less likely to be denied.

And it allows Schreiber and Kelsey to do this for a patient population that is often snubbed by gastroenterologists.

“I think many Hepatitis C patients have sucked a practice dry, where doctors just start seeing them,” says Schreiber. “It’s too labor-intensive. If I spend an hour doing a colonoscopy, it would b e a lot more profitable than treating them for Hepatitis C.”

Specifically, the course of treatment for a single Hepatitis C patient involves nearly a year of weekly treatments (which cost upwards of $80,000), blood work, symptom monitoring, regular communication with the patient, and constant contact with insurance companies for authorizations and to coordinate billing. If that weren’t enough, many of these patients are on medical-assistance programs and suffer from other chronic conditions and health issues, from high cholesterol to HIV. 

“What’s happened in recent years is as treatment for Hepatitis C has evolved, it’s also gotten more complex,” says Schreiber.

Before adopting an EHR, treating patients meant hours of paperwork, pulling charts, and going back and forth with payers.

Today, the practice is completely paperless, as every aspect of Hepatitis C treatment is coordinated through the EHR. As a result, Schreiber says he and Kelsey have been able to dramatically increase the volume of needy Hepatitis C patients they see, cut administrative time in half, quickly pull and update charting, and easily monitor patient progress to keep symptoms in check and to document that they are being cured of the disease.

Using an EHR also has curbed denial rates, as every document sent to payers is time-stamped, and medication interactions are checked (so patients who were on Lipitor, a cholesterol medication, and were denied Hepatitis C medication because of interactions, can be taken off Lipitor if necessary).

The EHR also helps the practice stay on top of blood lab reports.

“You have much less of a chance of missing things,” says Kelsey, adding that prescription renewal has gone from a several-minutes-long process to a seconds-long process. “It’s almost seamless because there’s no telephone calls, there’s no pulling the charts.”

In addition, the practice is able to cure more patients of the disease. Currently the patient’s success rate is 70 percent. What’s more, patients are able to see the treatment’s success through a patient portal.

“Patients love seeing that ‘non-detectable’ as much as we do,” says Schreiber. “They want to have that.”