Study – Large Multi Location Physician Group
Electronic Medical Records Implementation
Clinical and Billing Systems Integration
A non-profit network of multi specialty physician group practices
in over 30 locations had made a series of acquisitions and affiliations
with other groups over a period of years. The network that now consisted
of approximately 1,000 physicians recognized the need to implement
a single Electronic Medical Record (EMR) and clinical system that
would unite the groups in their ability to transfer patient medical
histories and procedures between various offices and specialists.
In order to implement the EMR system, the network had to deal with
two distinct but related issues. First, a large number of patient
encounters resulted from referrals made by physicians outside the
network in a multi state area. Second, all patient information originated
with the physician who utilized an internal clinical system that
was not fully integrated with a separate billing system.
The EMR implementation highlighted acute discrepancies between the
multiple provider databases. Past work-arounds and simmering grievances
from the clinical staff over the time consuming and often stressful
situations in which clinical information was entered in the clinical
system conflicted with the exact information requirements of the
billing system. Clinicians requested accurate referring physician
information be available in the system when providing patient care
and entering orders. Billing requested accurate referring data so
that claims were not rejected and re-work was not required in obtaining
correct provider information.
Folio Problem Solving
Folio was asked to review the current provider databases and processes
of the network. Folio implemented a solution that consisted of the
- Existing databases were rationalized using Folio’s proprietary
software tools to eliminate all duplicate, inactive and out of
- The databases were then matched to Folio’s reference database
of all active practicing providers within the network’s
- The network wished to maintain their own physicians’ information.
Crosswalk tables between the network’s databases and Folio’s
database were developed. The network provided Folio with monthly
electronic updates of changes in internal staff physicians and
Folio added and removed network providers each period to maintain
the crosswalk table.
- Monthly the network refreshed their provider data by incorporating
Folio’s reference database of over 50,000 active practicing
physicians in their multi-state region.
The network was able to pre-populate their systems with referring
providers and eliminated the substantial cost and time consuming
efforts required of clerical, billing and clinical staff to capture
referring provider information. Billing re-work declined with accurate
information and the elimination of duplicate providers.
The implementation of the EMR went smoothly and Clinicians accepted
the integrated data within the common EMR. The network achieved
significant cost savings with the common EMR versus multiple disparate
databases and the integrated EMR greatly benefited patient care.
Quantify the financial impact of
inaccurate and incomplete provider information with the Folio Analyzer