Alliance Spine & Pain Centers
Alliance Spine and Pain Centers focuses on non-surgical treatments for spine pain. Alliance has 14 outpatient surgical facilities approved by the Joint Commission on Accreditation of Healthcare Organization where they offer state-of-the-art modalities to help manage their patients’ pain. Alliance focuses on comprehensive care to fix the root problem behind patients’ pain, and have 19 locations, 24 Physicians, 19 Mid-Levels, and 25 CRNAs. Several of Alliance’s physicians received the Atlanta Magazine’s “Top Doctors” honor in 2018.
Alliance Spine and Pain Centers implemented eClinicalWorks® in 2006 with one physician and grew from one location to 19 locations quickly. Their rapid growth called for many functionalities that eClinicalWorks® did not offer at the time. The practice developed workarounds to address their needs, which, as eClinicalWorks® developed new functionalities, became problematic.
The practice’s previous internal eClinicalWorks® expert moved into another role. A new eClinicalWorks® Super User was appointed and Alliance contracted with Ero Health to provide the Super User Training. During the Super User Training Sessions, it became abundantly clear that most of the practice’s workarounds were no longer required due to new software development. Alliance then had to decide how to move forward with the no-longer necessary workarounds, which lost their customization with every eClinicalWorks® update. Upon additional consultation with Ero Health, the decision was made to rebuild the EMR system.
The Client's Need
The practice had workarounds specifically to handle clinic, surgical, and ASA operations. The scheduling set up and processes needed to be reconfigured as the practice scheduled by Resource, Facility, and by Visit Type. Provider reporting was challenging at best, and providers were unable to view their individual schedules.
The practice also needed to establish a consistency of workflow documentation across all of their centers, which aids the staff’s ability to find the necessary documentation to improve the pre-certification process; thus allowing patients quicker access to care.
Debby Macikowski with Ero Health worked with Allison Smith to completely restructure eClinicalWorks® to create a Standard of Care for all of Alliance’s Clinics and ASCs. This ensured that they would have all the functionality they needed, including better documentation and reporting processes, as well as a new way to schedule. Ero Health first started with cleaning up and rebuilding the existing database and redefining workflows for consistency.
Three physicians, Dr. Hord, Dr. Marshall and Dr. Gale, were appointed to champion the project and help define how the documentation would be captured in order to make clinical sense and be reportable. A main focus was to track Patient Quality Metrics specific to each patient. This involves the provider asking the patient to create a functional goal for their next visit, at which their progress can be tracked through quantitative scoring.
For patients who are receiving long-term care for chronic spine and pain issues, this is very helpful to track what improvements have been made in the patient’s quality of life.
Revamping a healthcare system which has been around for a number of years while it is still in use isn’t a simple process, and involved setting up domains for redevelopment, testing, training, and transitioning over. It’s important to note, that the EMR redesign and rebuild was done without impact to daily operations. Another large and integral piece of the transition process was training the faculty and staff on how to use the newly redesigned EMR system and provide documentation for the new processes.
Ero Health worked with Alliance’s new eClinicalWorks® Super User to create Training Manuals with straight-forward step-by-step instructions for each department. The first training session was for regional administrators and a chosen representative from each location, followed by a second training with their teams. Four all-day training sessions were provided, and staff were welcome to attend more than one training session. Training manuals were distributed to all attendees.
Changing how the schedule and visits are set up has made a significant positive impact in both patient wait times and providing the Medical Assistants adequate time to capture data in a consistent, timely, and accurate manner. Quality measures are now built into the system, and structured data can now be reported on. The practice has seen a decreasing pre-certification denials for procedures, which
means patients are able to obtain the treatment needed in a timely manner. Progress notes are now documented in a uniform way, which makes it easy to mine information. The custom drug database has been cleaned up, saving time searching for the desired medication and dose.
The EMR Optimization has prepared Alliance for the eClinicalWorks® ASC Module which will only further increase the practice’s efficiency and utilization of eClinicalWorks® functionality.