From the American Society of Health Informatics Managers (ASHIM)
Interviewed by Tom Criser, Published Sept 9, 2009 © ASHIM

Michael Q Stearns, MD, CPC, CFPC™

President and CEO of Michael Q. Stearns, MD is a board certified neurologist and one of the more experienced physician health care informaticists in the nation. Solution is a Texas-based electronic health record and practice management software company. Michael Q. Stearns, MD is a member of the ASHIM's Health IT Industry Advisory Panel, the Health Information Technology Standards Panel, and the AAPC's Family Practice Steering Committee.

Interview Topics:
5 Great TIPS FOR EHR Conversion
Why EHR is so exciting to industry insiders
3 Ways to Assess Vendor After Sale Resources

The Interview

ASHIM: It looks like after years of HIT planning and discussions things are finally starting to move rapidly. How excited are you about the future of HIT and EHR?

Michael Q. Stearns, MD: I have been waiting for some time for things to finally start moving in such a positive way. Electronic Health Records (EHRs) and related HIT efforts have the potential to change the healthcare industry in so many important ways that each day seems to bring new opportunities. I feel that by working together ASHIM, , and AAPC can provide leadership in critical areas. We are at the forefront and that is electrifying.

On the business side of EHR implementation, we have seen many practices convert to EHR and within 6 months they more than recapture their initial investment through more accurate coding so they are no longer leaving money on the table. It has been rewarding to see the combination of improvements in patient care, improved efficiencies in administration, and more accurate levels of reimbursement.

ASHIM: What are your recommendations for medical practices that are just starting to look into EHR?

Michael Q. Stearns, MD: The first step I suggest is to research the information that is available via your professional academy, society or college. Many have preformed fairly in depth evaluations of EHR products and companies, including features, usability, training, support, cost, and experiences of other physicians in your specialty. The American College of Medicine and the American Academy of Family Physicians are examples or two large organizations that have evaluated EHR product. These groups adhere to scientific methodologies and eliminate much of the bias that is often present in other sources of information.

Next, I would recommend evaluating the level of involvement the company has with standards, policy and certification organizations. I'm a big believer in companies who show they are deeply involved in the leadership of their industry. It shows a strong corporate culture when the executives are active in the industry by contributing their time and expertise to national and regional efforts to improve healthcare, including partnerships with academic centers.

As an example , our company, is in the process of developing educational and research partnering with several universities. Our goal is to help train HIT professionals and to lend our knowledge and experience to ongoing HIT and basic science research. I think this is an emerging trend, and something which our senior management team and board chairman David Winn, MD, FAAFP, is a logical next step for EHR companies.

Also, it is important to go visit several clinics that are set up and have gone through their learning curve. See what has worked for them and what still needs improvements. Most will be happy to share their successes and how they dealt with problems that emerged during their implementation process.

ASHIM: What else should one look for when deciding on a company?

Michael Q. Stearns, MD: There are many products out there which can fill many needs. I think it is essential to sit down with your prospective companies and discuss your specific specialty's needs. Go beyond a Power Point session and a canned presentation. Think ahead before the demo and ask the vendor to walk through typical documentation and work flow scenarios that occur in your office. See how well their tools mimic your experiences.

Given the incentives for EHR use in the stimulus package, make sure the vendor has the ability or a firm plan that will allow them to send and receive data required for physicians to become meaningful users.. Implementation and training is key to the success of any EHR go live. Assess their track record by looking at published data and by talking with clinics they have taken live. Will they send enough qualified professionals to implement the system in the shortest time and least obtrusive manner?

Do they have good training facilities and trainers? If possible, speak with the management team members that specifically oversee training and customer service staff. You are entering to a long term partnership with this company, so make sure you perform due diligence.

Last but not least, ask for references and call them for information. Most EHR companies depend on word-of-mouth referrals for their business. In order to get sites to serve as positive references, companies should be very service oriented. If not it won't take too many phone calls to current customers to get a good feel for where the company stands.

ASHIM: What kind of timetable should you expect when finally jumping into EHR?

Michael Q. Stearns, MD: I can only speak for , but I believe as a realistic estimate it takes most clinics about three to six months of vendor research before they choose a product. Implementation for us is typically about three months, but we currently are running a backlog of four months. As a reasonable estimate you probably want to give yourself a year before you are up and running. Given their requirements for meaningful use you may want to factor in some extra time to learn the system to the point where you are reaching these objectives.

We have seen many customers achieve a positive return on their ROI in their first year, often well above their initial investment. The second year is of course when we often see the biggest ROI. And, so far, we have reports showing continuing increases over time with patients, revenue generation, and proper use of clinical coding.

ASHIM: We understand EHR and the much efficiency it brings to a clinic, what beneficial ancillary business benefits have you discovered?

Michael Q. Stearns, MD: Good question! Most physicians are conservative by nature simply because of the complex decisions they have to make. That carries over in how they code for third party payers. Meaning, most clinicians are leaving thousands of dollars a year "on the table" because we don't want to create auditing problems.

EHRs have proven value with regards to coding accuracy, which has overall resulted in somewhat higher but justified coding levels. It also markedly improves charge capture for procedures and other billable items that have led to ROIs that have been much higher than we originally imagined.

To me, these are some of the more positive discoveries about the financial benefits of Health Information Technology. These are issues many people didn't consider or even thought about. In essence, recapturing the costs of the initial investment is accomplished to a great extent more rapidly than we had originally anticipated. That in itself makes conversion to EHR an intelligent business decision in addition to benefits that it can provide the quality and efficiency of health care in general. That's exceptionally exciting!