Case Study

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Advanced Foot & Ankle Specialists

Dr. Mark Leitner and Dr. Brandi Johnson of Advanced Foot & Ankle Specialists decided to get ahead of the curve and invest in an electronic health record (EHR) system as a way to bring efficiencies to their practice. They also knew that automating their office would help differentiate themselves from paperbased podiatry practices in the area.

The practice selected Doctors’ Administrative Solutions (DAS) because it offered the perfect combination of Aprima Medical Software’s EHR and practice management (PM) solution, excellent on-site training, and comprehensive lifetime support. Aprima had the capabilities Dr. Leitner and Dr. Johnson wanted such as e-prescribing and workflow management. Furthermore, it was easy to customize and would serve their office staff well.

The Conversion Process

DAS created patient records from the practice’s billing database, set up payer files, and customized Aprima to suit this practice’s preferred workflow. A DAS trainer spent several halfdays onsite working with the doctors, four medical assistants, and eight administrative staff members. That way, the practice’s staff could see patients in the morning. At go-live, DAS stood by to help. Amanda Patanow of DAS remembers, “Just two and a half days into the go-live, Dr. Johnson gave the system a 10 out of 10.” DAS was there side-by-side every step of the way, returning as necessary to ensure the practice was getting what they needed out of Aprima. Six months after launch, Dr. Leitner said, “Now I can’t imagine working any other way.”

Giant Strides In Efficiency

Dr. Leitner names increased efficiency as his favorite thing about Aprima. “Everything’s so much more organized,” he says. “The messaging center makes it easy for me to check routine messages at lunch and at the end of the day. I can also see instantly if another doctor is calling, so I can step out of an exam to take the call if I need to.”

Another favorite is the “pop-up note.” For example, if a patient has a balance due, Practice Manager Dina Richie can add a pop-up to the schedule reminding the front desk to collect the balance. “Our receptionists let patients know there’s a balance due when they call with the appointment reminder. And we don’t waste paper printing a bill if the patient doesn’t need it.”

Dr. Leitner and Dr. Johnson have four medical assistants (MAs) who take patient histories and vitals using laptop computers, then stay in the room during the exam and record the physicians’ findings on the spot. Aprima’s template-free design follows the flow of an exam. The MAs document the chief complaint, history of present illness, medical and social histories, and vitals. When the doctor comes in and begins the review of systems, the MA can easily follow along and chart in real time.

Real-Time Recordkeeping

“We’ve designed the exam in Aprima to suit what we do. It’s broken down into systems: constitutional, circulatory, musculoskeletal, and so on. Entries in the drop-down menus for things like diagnoses, drugs, and procedures are organized so that the ones we use most often are at the top of the list,” Dr. Leitner explains.

When Dr. Leitner walks out of the exam room, 98% of his notes are done. He reviews the chart later to correct or add information, but that doesn’t take long. Now, instead of spending 90 minutes every evening and two hours every weekend working on charts, Dr. Leitner goes home on time and empty-handed.

Meaningful Savings

Dr. Leitner estimates that the practice is saving $400-500/month in paperbased chart costs. Additional savings come from forgone printing costs (prescription pads, forms and photocopies). Staff is more efficient. “Now, you don’t have to worry about where the chart is, because everyone has access. Just pull it up, and boom! You’ve got what you need,” says Dr. Leitner. He estimates that the practice has reduced expenses by another $500/month due to improved efficiencies. Finally, the practice no longer needs transcription services, saving an estimated $600/month.

Clearly Better Charting

With Aprima, patients’ charts are complete, organized, easier to read, and easier to search. Dr. Leitner leveraged this to improve his medical-decision making since he can see the patient’s entire history without flipping through a stack of hand-written notes.

Aprima generates one-page referral letters for the practice. They’re faxed back to referring doctors twice a week. Dr. Letiner recalls that, “One doctor saw the note, said ‘Wow, that’s really organized,’ and asked what system we’re using.”

With DAS and Aprima providing fast, knowledgeable service and the practice’s data backed up on multiple servers in multiple locations, everyone at Advanced Foot & Ankle Specialists is confident that the Aprima system will be making them happy (and referring physicians jealous) for a long time to come.