Austin Regional Clinic to invest millions on e-records

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"As Austin Regional Clinic prepares to invest millions in electronic medical record technology, the physician-owned medical group has been meeting with EMR vendors and getting demonstrations of the latest technology.

"ARC's EMR requirements are a tall order. And it serves as an example of the careful planning and evaluation going into the acquisition of such technology at health care organizations throughout the country.

"As a large, complex health care organization, ARC is looking for EMR technology that will support its doctors and staff, and be easy for patients to navigate. Also, the technology will have to meet federal requirements to qualify it for available EMR incentive programs.

"Of course, ARC is also concerned with the bigger health information exchange picture. It plans to select an EMR technology that will help it in its goal to become an accountable care organization, a health care model that facilitates a continuum of patient care across different institutional settings, from primary care to hospital care to post-acute care.

"ARC executives aren't taking the decision lightly.

"'In over 30 years of being in business, this is up there with the top five important decisions that this group has ever made or will ever have to make. I'd rather make a good decision than a quick decision,' said Dr. Norman Chenven, founder and CEO of ARC.

"Started in 1980, ARC is now one of the largest multispecialty health care groups that's governed by physicians in Central Texas. It's affiliated with Seton Family of Hospitals. The network of 19 medical offices in Austin, Cedar Park, Round Rock, Pflugerville, Hutto and Kyle has 281 doctors focused on primary care, family practice, pediatrics or general internal medicine.

"ARC has been doing its due diligence in interviewing EMR vendors. At least one Austin-based company is in the running, e-MDs. Since the beginning of the year, e-MDs reports its sales have increased 36.5 percent. Its software is used by more than 2,250 medical practices in the United States.

"Chenven said ARC is working to develop a short list of three or four vendors in the coming months, after which it will issue a request for proposals.

"There are only a dozen vendors eligible to service an organization of ARC's size, Chenven said. And even those vendors might find it difficult to impress Chenven and the rest of ARC's leadership.

"Chenven said the ideal EMR would have the usability of an iPhone for doctors, administration and patients. While EMR technology has improved substantially over recent decades, he said it's not as easy to use as he would like.

"'It should make it easier and quicker to get an accurate diagnosis and collect all the necessary and important information,' he said. ‘It's not quite there yet, but every year the software design improves. But there is no killer app yet.'

"He also is looking for an organization with a proven track record.

"'Once you are on a system, you don't want to be changing,' he said, adding that the EMR technology will require a significant investment in time and retraining for all ARC staffers.

"Fletcher Brown, a partner in Davis & Wilkerson PC's health care practice, said his firm handles contracts for EMR purchases because of the expense of the transactions and to help ensure the technology will meet the definition of meaningful use established by the U.S. Department of Health & Human Services.

"'It's a complicated contract, and there are consequences for not meeting the meaningful use definition,' Brown said.

"The Obama administration is waving a carrot in front of health care organizations in the form of financial incentives to encourage health care organizations to invest in the technology. Starting in 2011, the Medicare and Medicaid Electronic Health Record technology incentive programs will provide incentive payments to health organizations and physicians that demonstrate meaningful use of certified EMR technology. Early adopters who meet the criteria are eligible for as much as $63,750 per physician.

"Chenven said the incentive payments will not be a driving factor in ARC's decision.

"'We are looking for the best EMR for us and our patients — whether or not we get that reimbursement. Sure, I'd love it, but that's a tertiary decision,' Chenven said.

"Given ARC's size and complexity, Brown said it's understandable that ARC would have a stringent process for evaluating vendors.

"As one of the largest health care organizations in the region, ARC's decision will likely have influence beyond its own organization, said Randy Hill, chief information officer for Integrated Care Collaboration, a nonprofit regional collaborative.

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