Customer Spotlight - Connecticut Family Orthopedics

Connecticut Family Orthopedics (CFO) is a 6 physician, 2 PA, orthopedic single specialty medical practice with offices in Danbury and Ridgefield, Connecticut.

Medical record keeping and billing consists of repetitive documentation and data capture tasks that offer excellent areas for technology adaptation.

For the past 30 years, technology has had a place in medical billing and accounts receivable (A/R). Many medical practices have consistently used "Practice Management" (PM) software for demographic information capture, accounts receivable and scheduling tasks. In the past 5 years there has been an explosion of "Electronic Medical Record" (EMR) software to compliment PM software, some integrated in one package and some interfaced with PM systems.

CFO maintained a PM only computer network until January 1, 2000, at which time separate PM and EMR software were interfaced producing a seamless application that allowed all tasks to be completed and shared in real time. At that time CFO began our technological journey...

January, 2004 - CFO began to use the new PM portion of the application to schedule and billing patients. Our billing operations were outsourced with billing positions terminated through attrition or assigned other tasks.

April, 2004 - CFO began to use the new EMR portion of the application and transition to a paperless medical record.

At this time data was accessed and stored on servers in-house that were maintained by an off-site hardware vendor. The disadvantages were many.... Support was accomplished by CFO staff with no training and by visits from the hardware vendor as needed... Simple issues had lengthy and expensive solutions due to travel time and availability.... Down time was frequent and painful...

Advantages were also realized:

In addition to payroll savings for terminated / reassigned staff, there was the real estate gained from removal of patient charts from our offices… Both have been successfully transformed into efficient workspace for business operations…. Patient’s records were now accessible from multiple locations…. Providers had access to our data from home anytime…. Chart searches were a thing of the past… Messages are e-mailed no longer handwritten….

That was the beginning… We are now 3 years into our transition with constant changes… As for the ways we have benefited:

• We now host our data in an” Application Service Provider” (ASP) model. Our data is maintained and backed-up by a technology company 24/7…GlobalNet Solutions. Problems are a phone call away and immediately resolved.
  
• Our original wireless network was disconnected due to "signal latency"... While the wireless network was not the culprit, we remain "wired" to this day and anxiously await its return in the future.
  
• Interfaces with outside vendors (Lab, X-Ray, Hospital) are in development.
  
• Digital x-ray is being investigated in-house, is already in place in the community and we are investigating displaying images in our exam rooms for providers and patients to view.
  
• Insurance card image scanning is in development.
  
• Insurance eligibility is accomplished in real time from the web sites of Insurance companies.
  
• Our billing company has access to our EMR and can print clinical notes as needed.
  
• Surgery images are digitally captured and imported into the EMR.
  
• Op notes, progress notes and dictation are digitally captured and imported into the EMR.
  
• We are developing patient registration on line that will deposit the demographic and insurance information directly into the patient record.
  
• We are developing interactive appointment making online that will interface with our PM software and enable patients to make real time appointments through the internet.
  
• We are investigating “ Voice over IP” digital options and “screen pops” for our telephone operators.
  
• Telecommuting has entered the medical practice arena with billing, dictation and providers working from home.
  
• Development of a fax server will enable us to fax anything we can print right from our desktops.
  
• Technology has allowed us to embrace e-mail with all it’s advantages such as: document attachments, remote access, etc.
  
• Staff efficiency and effectiveness has soared.
  
• We are using data mining software with our PM system that can massage our data anyway we choose. (This is great!)
  
• Custom encounter forms maximize the CPT, ICD-9 and documentation for charge capture.
  
• Custom encounter forms maximize capture of clinical information for present and future visits
  
  
  
  Gabe Carubia
  Practice Administrator
  Connecticut Family Orthopedics
  33 Hospital Avenue
  Danbury CT 06810
  Phone (203) 792-5558
  Fax (203) 731-3213
  g.carubia@cfortho.org
  www.cfortho.org