MD2U - A case study

Mobile EMR key for new “house call” practice design

In 2005, Dr. J. Michael Benfield, wanted to offer quality acute and primary healthcare in a private and personal setting in the patient's home. He wanted to provide the most convenient, detailed and service oriented medical care to meet the needs of patients by reducing the barriers many patients have in visiting a provider's office. To do this he founded MD2U, "doctors who make house calls."

MD2U wanted a cutting-edge home visit process that would allow providers to be focused on the patient with minimal intrusion into the patient-provider relationship. While paper was comfortable to work with it was inherently insecure, prone to misplacement and easily disorganized in a highly mobile situation of multiple venues. Efficiency of the charting management process was identified as key for a sustainable economic model that focused on mobility.

Finally, MD2U wanted to develop a prototype "house call" medical practice system that could be duplicated and scaled upwards.

The search begins.

Dr Benfield began to build the medical practice by seeing patients and hiring nursing staff for “home visits.” He also began looking for a qualified practice manager to keep the physical logistics of a mobile practice under control. He realized any future growth of his vision needed the expertise to handle the timely dispatch and co-ordinating of providers to patients. Greg Latta, who spent many years in the event business with heavy logistics and time sensitivity needs. Latta’s task was to create a system that would maximize the number of patients seen daily while at the same time allow providers adequate time to build a relationship with each patient.

Latta quickly realized the limited security of a paper medical chart with its physical limitations would restrict the vision of MD2U. For mobility an electronic medical records, EMRs, would definitely be easier to manage than paper charts. The risk of losing live patient medical information contained in a paper chart, a laptop or Tablet PC would simply multiply over time as MD2U grew. A centralized data base with live access was necessary to insure security. Stacks of paper charts being transferred from vehicle to vehicle would be very inefficient.

Technology was advancing, and Latta began looking at cutting edge EMR vendors and how they could leverage the newly introduced high speed wireless Internet by large cell phone companies. A vendor with software that could create, import and manage scanned forms for an was a key consideration along with the ability to function in the developing wireless Internet technology.

“The free fully functional Medscribbler Lite gave me the opportunity I needed to work on getting the technologies working without risking a huge investment. Were we to go with one of the other systems it might have resulted in months of time and investment without return. The Medscribbler staff was always available to help in getting the software to work for us before the sale. Others were relentless in their sales pitches to buy first. Medscribbler built a relationship, which was important to us.” — Greg Latta

The test begins.

MD2U was beginning to build a base of patients and new medical staff was being hired. The problems with a paper chart were beginning to be very evident. The Medscribbler Lite Server was installed at the central office on a computer with an ordinary broadband DSL connection to the Internet. The medical providers were given Tablet PCs with Verizon “aircards” for the Medscribbler Client application. Real-time use was begun in order to measure Medscribbler's effectiveness.

Dr. Benfield was impressed, “The best feature is the ability to create our own charting format and use it as if it were paper while at the same time storing and retrieving information like more tradition EMR systems, a well constructed hybrid.”

Very quickly it became evident Medscribbler was up to the task. Limited training time was required for staff because of Medscribbler's intuitive nature. A few minor problems in Medscribbler navigating the wireless network blind spots were overcome quickly by Medscribbler staff providing software remedies.

Medscribbler could be relied upon. Use of Medscribbler Lite continued for several months.

A decision is made.

Because of the practice growth and the positive results with the free Lite version the decision was made in the summer of 2006 to purchase Medscribbler Pro. The upgraded Clinical Processor allowed better user management and added many features but had the same core features of Lite which allowed minimal staff disruption in adapting to new software.

As MD2U continued to grow, new staff like using Medscribbler because it “really is just like writing in a paper chart” and “it is real simple to use.” Potential new staff who have used other vendor’s EMR software comment that Medscribbler “looks like it is easier to use” and “a lot of extra typing can be avoided.”

Latta comments that “from the start we have successfully grown with Medscribbler.” We are now released from the physical limitations paper charts placed on our potential growth and now have the ability to grow geographically. The limiting factor is now only the development of Internet broadband wireless, which is improving rapidly in both reliability and coverage.”

Because of the success with Medscribbler, MD2U has expanded into other cities and now offers a franchise package that includes Medscribbler to allow other providers to begin to use the low overhead, quality patient centric care that MD2U has proven to work.