Interview with Dr. Shawn Howerton (DoctorsPartner EMR/PM user): “EMR is a matter of style.”

In an exclusive telephone interview, I spoke with Dr. Shawn Howerton, Roseboro, NC family practice physician, who, in partnership with his wife, Amy, (www.howertonfamilymedicine.com) has used DoctorsPartner EMR/PM software (www.emr-electronicmedicalrecords.com) for the past nine months. (As you know, I am sponsored by DoctorsPartner, so I was hoping for a particularly positive interview. I am happy to report that a nicer, more down-to-earth, more positive EMR user would be hard to find!)

My first question for Dr. Shawn Howerton regarded the effectiveness of EMR marketing. How did you find out about DoctorsPartner?

“My first exposure to DoctorsPartner was on EMR Update,” answered Dr. Howerton. (Take note prospective EMR advertisers.) “The EMR Update Forum has been a Godsend for me. It has saved me many hours of looking at EMRs that just weren’t my style. Colleagues have had good success with EMRs which I looked at but I could see they weren’t for me.”

I asked if he is using the standard, out-of-the-box product configuration — have any of the EMR or billing screens been customized at this time?

Dr. Howerton replied, “We haven’t had to change the product from the way it came. We’ve had a few ideas for customized screens, but the other doctor I work with [his wife, Amy] and I haven’t been able to agree on these changes.”

After only nine months of EMR use, often some aspects of EMR implementation are still in progress. How about in Dr. Howerton’s case?

“Yes,” remarked Dr. Howerton, “we are still converting some paper documents into the EMR, and we’re still working with our lab vendor to work out the interface with DoctorsPartner. This is getting closer and closer every day. The DoctorsPartner staff have been extremely good to work with, they’ve been very helpful. To be honest, when you are looking to purchase their software, DoctorsPartner is very helpful--which not all EMRs are. Especially some of the bigger companies. We have one full-time and one part-time doc. When the larger EMR firms learned how small our practice is, they wouldn’t return my calls or weren’t very accommodating at all.”

“You’re kidding me,” I gasped.

“No, not at all,” the doctor explained. “I can’t tell you how many EMRs I looked at where the vendors brushed me off with a horrible lack of customer service or even any sense of tact. One vendor [who will remain nameless] actually told me they wouldn’t be interested in working with any practice smaller than 150 doctors.”

What did this “unique shopping experience” teach Dr. Howerton about the EMR industry which he would like to share with other doctors?

“I don’t think there is one EMR for everyone. You have to really be honest with yourself in regard to your particular style of note-taking and then choose an EMR that fits your style. Some have all push-buttons and some make you type everything in, but I think we found a good compromise with DoctorsPartner, and over all, we are quite satisfied.”

Dr. Howerton continued, “I’m sure there are doctors who are not very computer savvy who will never be satisfied with any EMR.”

I asked, then, how computer savvy are you?

“I am a computer geek,” he stated, “but I wanted an EMR that was useable and not terribly complicated. I wanted an EMR that was intuitive. This is a new office. Over the past year, I have gone through quite a few staffing try-outs, trying to find the right people, and have had no difficulty in training new staff members on DoctorsPartner myself. This would not have been as easy with any of the other EMR software I’ve seen. This was a big factor in our buying decision. I believe the intuitive design of the DoctorsPartner software has saved me about a thousand dollars in training costs for every new employee, which I would otherwise have had to spend.”

He added, “The way DoctorsPartner is set up, and this is done for every customer, a ‘test system’ is maintained—along with the active, real system--on which to practice EMR operation and technique. This is a ‘dummy’ system—which appears to be real--that we use for training new employees so they don’t have to worry about wrecking anything. It has worked out well for us. The vendor is very open to suggestions from us, and they can also try out their solutions on our test system for us to try. It’s been wonderful.”

How about pricing? At $350 per month per doctor, (See http://www.emrupdate.com/resources/pricecomparisons.aspx for EMR price comparisons) how did the DoctorsPartner pricing model influence Dr. Howerton’s first-time EMR purchasing decision?

Dr. Howerton replied, “I was impressed with the reasonable start-up price. What I am paying DoctorsPartner each year is less than many EMR vendors wanted to charge me for updates and maintenance per year. I’ve had good success with the product. Of course, there have been some frustrations along the way, but these are mostly due to making the change from paper to electronic records, rather than any problems inherent in the software or the vendor. DoctorsPartner is a solid EMR and billing software product that works, and it fits our style. I see and completely document about 20 patients per day, and at the end of the day, when I’m done I’m done.”

I asked Dr. Howerton what he means by “style”. How would he describe his documentation style?

“I don’t use a lot of check boxes, particularly in the HPI. I like to type out in my own words the most descriptive sentences I can muster. I listen to the patient carefully, and I try to capture in the medical record exactly what the patient is saying,” he laughed, “as opposed to checking off ‘cough’, ‘runny nose’, ‘sore throat’”.

What is Dr. Howerton’s exam room computer of choice--tablet PC?

“No,” he said, “I have a tablet computer, but I prefer to use a laptop. As I mentioned, in the HPI, I like to type out more detailed descriptions, so I need the keyboard more than I need an easy way to check off boxes. Again, it’s a matter of style, and the laptop just fits my style better than a tablet. I type when I need greater clarity, or I whenever need to emphasize something.” He did not mention the use of voice recognition software.

Does Dr. Howerton use the feature in DoctorsPartner which allows selected screens to become “invisible” to certain users?

“Yes,” he stated, “I find it very useful to eliminate confusion and distraction by limiting users to just the screens they need to do their jobs. This is also a feature that makes it easier to train new staff members. Everyone doesn’t have to learn everything about the product right off the bat.”

What else, I asked, can you share with other doctors about this product?

“DoctorsPartner is definitely a great piece of software,” commented Dr. Howerton, “but truly, one of their biggest assets is Naveen because he is so customer-service oriented. If there’s a problem, he’s working on it with his technical staff and it gets resolved quickly. We don’t have to wait three months for the next update. Naveen knows the meaning of the word ‘now’. But he doesn’t just sit back and say, ‘Hey, we have a pretty good product, let’s just sit back and relax.’ They’re always working on the next step, what else to add, how to make the product better. And I’m rooting for them because I know I’ll receive all the enhancements free. I know that immunization and growth charts are coming out soon, which will be automatically installed on my server by the DoctorsPartner technical people, and I’m looking forward to those additions.”

“Actually,” he elaborated, “the software already has a few nice features I haven’t implemented yet, such as the built-in ‘Call and Forward’ automatic appointment confirmation system. Right now, my receptionist is confirming all the appointments, and it’s a real chore. This is a way to save at least thirty minutes of her time every day, and I intend to take advantage of it in the future.”

Any pet peeves regarding the EMR industry?

“Modules,” quipped the doctor, “that’s the biggest joke of all time. The vendor will show you the full-blown system, but sell you the base-line product. Several modules and $20K later, you are up to speed, but feeling somewhat abused. I am annoyed that some vendors are charging more than they should because they can get it. It’s like renting a room for a meeting, then renting the same room for a wedding. The wedding rental is doubled. If it’s medical-related, well, doctors can afford it, so let’s stick it to them. A lot of the EMR salesmen are like used car salesmen. They feel you out and see what they can try and sell you, and what you’ll bite on, and if that doesn’t work, they’ll lower the price. With DoctorsPartner, there’s no hem-hawing about the price. No trickery. If you go to their website, it’s right there, instead of ‘Contact a salesman and we’ll come up with a price’.

How’s the reliability of the software?

“We’ve never had a crash or lockup of the DoctorsPartner software. One of the best things to me is the ability to log in from anywhere and see my files. We also do an offsite backup every day, and we feel much more secure about the safety of our records than we ever did with paper. Here in North Carolina, we are looking at Katrina-type situations. Paper is delicate stuff. I’ve had a very good experience switching over from paper to EMR, and DoctorsPartner has made it very easy for me. This is a very complete system which constantly gets better. But the thing I like best is that it just seems to fit my style.”