A Clinician Round Table on EHR Technology Requirements in Concierge Medicine

Only by listening to clinicians can EHR technology designers and developers hope to create clinical documentation systems that are both user-friendly and improve efficiency. Most EHR systems fail miserably on both counts. It’s no different in “Membership Medicine” (i.e., DPC, concierge, cash-only, and hybrid models), where most clinicians are highly dissatisfied with current EHR technology.

The purpose of the following virtual roundtable discussion with two clinicians is to discover exactly what Membership Medicine requires from an EHR system. The clinicians are Dr. Dan Weeden, a DPC physician in Rogers, AR, and Dr. Cynthia Croy, who owns a hybrid DPC/cash practice in Joplin, MO. The clinicians are joined by Evan Pankey, Product Manager for Pri-Med InLight, an EHR with special features for Membership Medicine practices.

The first part of our discussion focuses on the challenges of running a practices from a business standpoint and issues like billing and managing patient-members. The second part to be published later this month will focus on clinical issues and how EHRs can help (or hinder) the delivery of quality care to patients.    

DPC Journal Editor: Let me start by asking each of you to give us a little background about yourself and how you got into Direct Pay Medicine?

Pri-Med InLight RGB-REVDr. Croy: In 1999, I started an independent family practice and was happy for many years. Everything changed in 2011 when our office was destroyed by a tornado, my partner left the practice, and the Accountable Care Act (ACA) was passed. Local employers started offering healthcare plans with very high deductibles to their workers, and some of our patients didn’t understand their financial responsibilities. We had to write off a huge amount of bad debt, and that’s when I realized the traditional insurance model wasn’t sustainable for independent practices. I learned about Membership Medicine from a webinar by the AAFP (American Association of Family Physicians) and decided it was the right path for me.

Dr. Weeden: My story is pretty similar to Dr. Croy’s. For nearly two decades, I worked as an employed physician at Mercy Health, which is the largest healthcare system here in Arkansas. Mercy was a great employer, but I often yearned to open my own practice. One of my younger colleagues, Dr. Joel Fankhauser, had a similar dream, and at the end of 2014 we decided to leave Mercy and open a Membership Medicine practice together. Having dealt with the onerous requirements of third-party payers for years, we both wanted to eliminate insurance claims and go with Membership Medicine.

Designed by clinicians, Pri-Med InLight is free to try and ideal for today’s independent primary care practices.

Click here to schedule your demo and see why.

DPC Journal Editor: What kinds of challenges did you face in starting your practice, particularly with regard to EHR technology?

Dr. Croy: I’ve actually been involved with EHRs for longer than most physicians. I used the same EHR for about eight years but it just had too many bells and whistles for my new Membership Medicine practice. Because I was starting up a practice without a partner, one of my biggest concerns was cutting costs, and the EHR was a major monthly expense. I was paying for features I just didn’t need. I ended up switching to an EHR called Pri-Med InLight that is designed for Membership Medicine practices. It’s about half the cost of the EHR I was previously using. I felt comfortable switching to Pri-Med InLight because it’s from the same company that develops Amazing Charts, an EHR I beta tested way back in 2002.

Dr. Weeden: My practice partner and I tried and rejected a number of EHR systems. At Mercy Health, we had a similarly negative experience with the hospital EHR. It was too costly, and the complex coding was more than we needed, so we immediately crossed it off our list. Assuming we just needed a basic record, we tried a free EHR from a well-known practice management software company. But we found the software was unreliable and ultimately we could never get it to run in our office. Next, we purchased an EHR designed by Membership Medicine physicians. But it didn’t support e-prescribing, and the patient record was disorganized. It was one long page, so we had to scroll endlessly to find anything.

DPC Journal Editor: You tried and rejected two different EHR systems?

the_doctors_guide_t_cover_for_kindlejpgDr. Weeden: Yes, it was really frustrating to waste so much time. I thought our EHR “wish list” was pretty reasonable. We wanted to handle our clinical documentation and financial operations in one package. We wanted e-prescribing. We wanted an intuitive, well-organized system to make us more productive. After being burned twice, we were determined to really test out our next EHR before we committed to it.

Evan Pankey: Many EHR developers misunderstand the needs of clinicians because they don’t spend enough time talking to them. We immersed ourselves in Membership Medicine for the past 12 months and have come away with a pretty clear understanding of what’s needed by this market. Dr. Weeden just mentioned the financial side of the practice, which is exactly where the needs of Membership Medicine are so different. In many cases, patients sign-up for a membership, and the practices don’t have the tools to track members, bill them monthly or annually, or offer them different tiers of services. EHRs and fee-for-service oriented practice management systems just aren’t set up to handle those jobs without expensive add-ons modules with extras costs.

Pri-Med InLight EHR is free to try and has special features for membership management practices to help you manage practice revenue, increase your subscription base, easily communicate with subscribers, and more.

Pri-Med InLight offers an intuitive method for organizing clinical records and practice workflows, making it faster, easier, and more satisfying to use. With an innovative patient engagement solution and a system that learns how you treat your patient’s problems, you’ll enjoy well-structured clinical documentation and efficient order and prescription workflows.

Designed by clinicians, Pri-Med InLight is free to try and ideal for today’s independent primary care practices. Click here to schedule your demo and see why.

End of part one. In part two, the clinicians discuss patient care.


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