Time isn't just money; it can improve patients' lives

CliniSync Success at Cardiovascular Medicine Associates

Working with anywhere between 6 to 11 physicians at any one time, staff at Cardiovascular Medicine Associates outside of Cleveland, Ohio, handled hundreds of pages of lab work every day

With 40 to 50 patients on average in the hospital daily -- not to mention the proliferation of office visits for 20,000 plus patients -- can make the numbers overwhelming.

Like data sludge, those test results chugged their way through a fax machine, countless pages that might have encountered no paper, be sent to the wrong location, or whose destiny just never found its way into the patient’s paper chart.

Just as often, those results became a conversation between doctor and patient, between staff and patient, between the practice and the hospital or lab, resulting in time spent on the telephone in what often can become an endless rendition of phone tag. Time ticking away, for staff, for physicians, and ultimately, for patients.

It’s not that the practice wasn’t efficient and effective. Everyone was doing their best. It’s simply that this is the way we were in the paper world of medicine.

The lost chart in the paper world

“It was archaic. We got everything by fax, phone calls or mail. Results were coming at us from multiple directions, any way possible. It was chaotic,” says Cindy Volk, RN, the practice administrator at this busy cardiovascular group that has received high results for patient satisfaction.

In the paper world, staff would attach the lab work to a chart, put it on the doctor’s desk where he or she would address it, and then put it back on the front desk. If it the lab work was ordered at a visit, staff would have to call back the patient saying everything looks fine, she says.

“If the patient would call and say, ‘I have a question,’ there was no way to know where that chart was. It could be on the doctor’s desk, in the doctor’s box coming back out, anywhere. Everybody was searching for charts, all day long,” she says.

In 2012, the practice went through culture shock when it purchased its first electronic health record system, also known as an electronic medical record (EHR/EMR) through Medent. For at least a year, the practice used a dual paper/electronic system because staff couldn’t scan 20,000 charts into the EMR. They did it slowly, scanning the lab work into the EMR, one patient at a time.

The digital world structures chaos

It’s 2015 now, and the practice is connected to CliniSync, the statewide health information exchange, which started rigorously sending lab results, radiology and transcribed reports directly to physicians from hospitals in 2013.

Cardiovascular Medicine Associates now receives structured data from Southwest General Health System and will soon be connected to University Hospital’s Parma Medical Center.

“While we had a much better system, it’s still not as good as the results delivery from CliniSync. We knew it was coming, but we didn’t know how good it would be,” Volk says.

At an Ohio State Medical Association meeting, the practice learned about CliniSync, and moved forward with the connection. But it took work between the vendor and the practice, and then the practice and CliniSync, to get the right information in their hands.

At first, everything they received from CliniSync filled up the doctors’ inboxes and they realized quickly that they were experiencing information overload. Cardiovascular physicians only need to see certain information, and they realized that information was “structured data.”

Working with their EMR vendor, they identified that any lab work or testing done as an outpatient remained in the inbox, and everything else dictated and signed needed to go into the patient’s chart in a closed status.

Useful data helps track trends

Now, staff can actually search for labs, creating flow sheets and graphs so they can track patient progress and trends. For instance, Volk explained that they can look at all of their patients who take Coumadin, a drug that prevents heart attacks, strokes and blood clots, so they can ensure they have their patients’ blood levels checked within one month.

The same holds true for patients with high cholesterol. The structured data populates a flow sheet and staff can see prior results, all side by side rather than trying to compare different documents. The practice now has five to six different lab results documents where they track and trend. And they’re now able to look at medications, diet and other factors for treatment.

CliniSync saves time, money

“The time savings and efficiencies gained are immeasurable,” she says. Staff members can address issues immediately with a patient on the phone. They can see the lab results and can communicate back to the patient quickly.

They’ve been able to save money on full-time employees, such as someone who would prepare charts by tracking down medical information prior to any office visit. That individual would have to go into a hospital’s system, print the labs and reports so the doctor had it for the patient’s first office visit.

“Now, all of those documents are automatically in the chart already. I have a part-time person just verifying that they’re there.”

What’s the best result of health information exchange? “What’s mostly gone is hunting for charts, tracking down where those lab results or documents are. And patients are happier. We can have a patient’s lab work done yesterday, and we’re calling today to give them the results.”

Dottie Howe is Communications Director at CliniSync/Ohio Health Information Partnership.


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