Moving Ahead on Electronic Health Records

I recently had an opportunity to interview James L. Holly, M.D., CEO and one of the founding partners of Southeast Medical Associates LLP, (SETMA), a multi-specialty clinic located in Beaumont, Texas that is an early adopter of electronic health records. His vision, and the accomplishments of his organization on EHR, hit home for me the huge potential of EHR to improve patient care.

SETMA purchased its EHR system from NextGen Healthcare Information Systems in 1998, just three years after the organization was founded. Holly says he wanted more than a glorified patient accounting system. His group immediately set about customizing the EHR system. It developed in-house a series of disease management tools, or templates, that allow each physician to document the condition and course of treatment of the patient. “That’s when it all changed, because we were able to do things we could not previously do,” Holly says.

Over the years, SETMA has made great strides in developing its system of patient care, and in the process it has changed the way its providers interact with their patients. It has developed into a sophisticated example of the Patient Care Medical Home that takes a team approach to patient care. A key component of that is its Care Coordinator team that follows up with patients who require more than two interventions. The team makes sure the patient has his medications, understands the physician’s instructions, and helps arrange follow-up visits.

About a year and a half ago, SETMA added quality audits into the mix, acquiring Cognos business intelligence software from IBM Corp. That has enabled the group to perform extensive datamining. This includes trending of outcomes, analyzing patient populations to ensure that all patients meet their health goals, and analyzing provider performance through statistical measures. In September 2009 Holly took the next step, announcing that SETMA would begin public reporting of provider performance. Holly says that performance reporting will have a transformative effect at SETMA,which will improve and change the dynamic at the organization.

To be sure, SETMA's commitment to EHR and quality metrics has been a long journey that has been a learning experience for the provider group. Holly notes that SETMA began its journey without a roadmap, but the group has documented real improvements in patient care quality. The important thing, he says, is to get started. His advice to other provider groups: “Once you get started, you can improve and do remarkable things, and do them faster and cheaper than we did them.”