Case Analysis: Multispecialty Group Practice EMR
The United Cerebral Palsy of Greater Birmingham (UCPGB) has recently moved to a new LINCPoint facility and identified the relocation as an opportune time to develop an electronic medical record keeping system. The UCPGB is a not-for-profit organization that provides various clinical health services to patients that have been diagnosed with Cerebral Palsy within the population of Birmingham, Alabama and reaches to the ten surrounding counties. The UCPGB is funded by a mixture of private and public funding, with most of its funding coming from the community through a parent organization, The United Way of Central Alabama. It is committed to providing a wide variety of services on site that address the complete health needs of its patients. The new facility has been designed with consideration of the patients’ limited mobility, its square footage totals 42,000 with 8,000 set aside for service delivery. The move to this location has prioritized the need for an electronic medical record to maximize efficiency and improve health care delivery. UCPGB provides Family Medicine, Physical Medicine and Rehabilitation, Exercise and Physical Therapy, Speech Language Pathology, Occupational Therapy, Optometry, and Dental Medicine. Due to the medical condition of these patients, most if not all patients utilize every service available and are followed by a multitude of providers. Each specialty is run in a different way; for example many of the therapy sessions are conducted in a group setting where one provider is working with multiple patients at one time and patients are often fast tracked to specialties. The center has many full time providers, nurses, therapist, dentists and auxiliary staff. It also has volunteer faculty for many of the specialties and allows residents to rotate for training purposes. Due to the nature of addressing the needs of the complete patient, many departments have special processes and protocols which lead to a diverse medical record.
The center suffered from huge inefficiencies with the paper system they had in place, ranging from inaccurate appointments to loss of patient information to constant repetition of tasks. However, the atmosphere in the center is of a pleasant informal nature and all the personnel are extremely devoted. They were aware of the inefficiencies but their devotion lessened their frustrations with the paper system. The personnel were open to change and supported the implementation of the electronic record. This case shows the obstacles associated with implementation of an electronic medical record in a center that has multiple specialties and multiple providers that have been working on a complete manual paper system. The review paper will address the nature of the organization, its willingness to improve, its accuracy in assessments of its current state, identification of goals and its strategy to achieve the goals it set for itself with consideration of the obstacles it would face.
While UCPGB realizes that they must update their paper system to an electronic one, many barriers stand in their way. The first of their concerns is financial. As a non-profit organization, UCPGB has limited funds for an EMR. The organization directs 93% of their funds towards support and improvement of programs and services. Unfortunately, funds raised to build their new LINCPoint facility did not include an allocation for an EMR. Commercial EMR systems are expensive and vendors often set their prices based on the number of users. This is problematic for UCPGB because they currently staff one full-time physician, 10 volunteer faculty and a large group of residents.
UCPGB must also make sure that their EMR is reliable and fast. The system cannot afford any downtime during clinical hours and data cannot be lost due to software or hardware failure. The best way to avoid downtime is to back-up data on multiple disks within one or...
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