How To Use Praxis

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1 Praxis EMR Case Studies For more client case studies in a variety of medical specialties, go to Our most recent and extensive case study covers Jeremy Bradley, MD, winner of the 2012 HIMSS Davies Award for excellence in electronic medical records. Dr. Bradley made amazing strides in medical quality, efficiency, and revenues by implementing Praxis EMR. The full (40 page) case study can be found here: _Jeremy_Bradley_MD_PSC.pdf The studies are fascinating and show quantitative and qualitative indicators of improvement. Dr. Bradley increased patient intake by 28%, increased revenues by 45%, and achieved recognition for medical quality in a number of areas. Two shorter case studies are presented below.

2 Praxis EMR: Dermasurgery and Mohs Surgery Case Study PHYSICIAN PROFILE Name: David H. Friedman, M.D. Specialty: Dermatology, Dermasurgery, Mohs Surgery Clinic: Northridge Dermatology Associates Website: Location: Northridge (Los Angeles), CA Background: Dr. Friedman has been in private practice in Northridge since He trained at the UCLA Medical School, completed his dermatology residency at Harbor UCLA, and serves as a Clinical Professor of Dermatology at USC, as well as a Clinical Associate Professor of Medicine/Dermatology at UCLA. Dr. Friedman began using Praxis full time with patients in Like many physicians I was becoming increasingly disenchanted with the practice of medicine, but with Praxis easing my stress and frustrations, I again look forward to going into the office every day. EMR Decision Why use an EMR? My practice had always used dictation since hand written notes are too slow and often incomplete, as well as an in house transcriber because outside transcription was either too slow and/or too inaccurate for dermatology. We then switched to voice recognition software to decrease costs. I was becoming awfully frustrated with dictating the same things over and over. Even with using macros and personally made templates the quality of my records was not satisfactory and I thought I was spending far too much time on record keeping. I was becoming increasingly irritated by misplaced charts and the inherent inefficiencies of running a paper based practice. With Praxis, my practice is now paper less. I will see patients daily, [ ] and need a system that can keep up with my practice I have been very pleased with how Praxis has been able to accomplish this. Decision for Praxis I will see patients daily depending on the number of surgeries, and need a system that can keep up with my practice. I investigated EMR s before deciding on Praxis. Others left notes that obviously looked like they were generated from templates, or could not handle the graphics requirements necessary for dermatology. I delayed implementing Praxis until it could handle the graphics needed for dermatology including documenting pictorially locations of biopsy sites,

3 locations of treated lesions and photographic documentation. I have been very pleased at how well Praxis has been able to accomplish this. It is great to be able to pull up a photo of a patient's mole on my pen tablet while seeing a patient to see if it has changed since the last visit. Physicians who refer patients to me for Mohs surgery have been impressed with the quality of my referral letters and that they arrive by fax the same day I see the patient. The Advantages of PRAXIS for Dermasurgery and Mohs Surgery With Praxis, I can rapidly and comprehensively document a patient who complains of actinic keratoses, Seborrheic Dermatitis, Rosacea and needs 2 biopsies to rule out skin cancer within a few minutes. Unrivalled streamlined, comprehensive and customized patient automation I can now quickly fine tune the history taken by my medical assistants, rather than spending an inordinate amount of time asking all the history questions myself. No lost or missing charts. No delayed review of lab results or prescription refill requests as it is all automated and available to me as soon as they arrive in the office. With Praxis, I can rapidly and comprehensively document a patient who complains of actinic keratoses, Seborrheic Dermatitis, Rosacea and needs 2 biopsies to rule out skin cancer within a few minutes. The documentation will include diagrams of the actinic keratoses treatment sites and biopsy sites, the location of previous biopsy sites, a form/label will print out to slap on the biopsy bottle, prescriptions will print out and the documentation to justify the level of coding will be automatically present. I used to routinely undercode because even though I provided the service, the documentation to justify it became too onerous to routinely include in the note. With Praxis, Documentation is no longer an arduous job, but a task I thoroughly enjoy doing. I used to routinely undercode because the documentation to justify it became too onerous... With Praxis, documentation is no longer an arduous job, but a task I thoroughly enjoy doing. Better quality staff training Training new medical assistants has now been made much easier by Praxis as procedure set up instructions automatically appear before them when they bring the patient into the exam room. It doesn t stop there we recently invited a new physician to join our practice. The Knowledge Exchanger will allow him to much more rapidly document his patient visits accurately and blend in to our practice style. Agents, the Incomparable more than just a memo system I'm sure you've heard how Praxis built in memo system, Agents, is far more than just a memo system and greatly improves communication and efficiency in the office. One of its abilities that I find very helpful is that a reminder message will automatically pop up at predetermined times. For instance if I open a patient's chart to enter a pathology report, when I read the biopsy slide a window will pop up reminding me to call the patient with the results since for whatever reason this particular patient isn't returning for a follow up visit. I can also have a window pop up when I open the chart for a patient visit reminding me to check a spot I noted on the last visit to see if it should be biopsied, or that the patient s spouse died the previous month or any other reminder I want to

4 see, but don't necessarily want to document in the chart. No question that my reimbursements have increased as I now properly code for visits instead of routinely undercoding Using Praxis is not only more cost effective for me, but also easy to use More reimbursements No question that my reimbursements have increased as I now properly code for visits instead of routinely undercoding. I can easily do this because of the automatic documentation from Praxis that requires no extra time or effort from me. Using Praxis is not only more cost effective for me, but also easy to use. Final Thoughts I could not be more satisfied with Praxis EMR. There are innumerable ways large and small that Praxis has made practicing medicine easier, more efficient and many a time pleasurable for both my staff and myself. Like many physicians I was becoming increasingly disenchanted with the practice of medicine, but with Praxis easing my stress and frustrations, I again look forward to going into the office every day. There are innumerable ways large and small that Praxis has made practicing medicine easier, more efficient and many a time pleasurable for both my staff and myself.

5 Praxis EMR: Otolaryngology PHYSICIAN PROFILE Name: Heidi Heras, M.D Specialty: Otolaryngology Clinic: Heidi Heras M.D., PC Location: American Fork, UT Background: Dr. Heras has been a practicing physician for 9 years. She trained at the University of Utah School of Medicine in Salt Lake City, Utah, and did her residency at the Albany Medical Center Hospital, New York. After a 6 year solo practice when Dr. Heras first encountered Praxis, she switched to a multi speciality clinic. After 2 years, and many frustrations with a template based EMR provided by a mainstream healthcare IT provider, Dr. Heras is back to solo practice, and has been using a full implemented Praxis system for a year. When I first saw Praxis I was happily surprised to see a system work a lot like I already practiced We had a lot of technical problems with the other system we had been using, which can be a catastrophe for a paperless office! EMR Decision Why use an EMR? In today s world paper just is not an option. With decreased reimbursement and the need to see more patients and do more in less time, and EMR is now not optional, but essential. Decision for Praxis When I first saw Praxis demonstrated at our Otolaryngology Academy meeting, I was happily surprised to see a system work a lot like I already practiced. It was by far the most affordable as well. I have worked on a much more expensive EMR when employed with a multi specialty clinic and know they spend many hundreds of thousands of dollars a year on support and the program, even when their system was simply not as robust as Praxis in being able to mold and flex with unique situations and patients. We had a lot of technical problems with the other system, which can be a catastrophe for a paperless office! I have had minimal problems with Praxis even in the beginning when we were trying to get all the hardware and software worked out. The technical support team

6 has always been super at getting our questions or problems worked out quickly. The Advantages of PRAXIS and Otolaryngology I am usually done with my charting as the patient exits the exam room. The fast coder is great and is like having a PDR and ICD9 at your fingertips. User Friendly Interface My visits are 100% automated. I can build new procedures on the fly and it is so user friendly that I am usually done with my charting as the patient exits the exam room. The fast coder is great and is like having a PDR and ICD9 at your fingertips. It is so much easier to keep track of medication refills and patient phone calls. It is great not to have a missing chart when a note needs to be made or a phone call answered. We use many of the Praxis Support Agents, but we are still learning some of the functions that Praxis offers that we have never used or thought we needed, but we do! Praxis is really encouraging me to become even more efficient, with all its easy to use functions; from online lab results to faxing and Agents. Personalized patient and physician experience I love the closing page of the visit. It gives a line that repeats the first diagnosis that was placed in the assessment so that when you do a chart review you can see at a glance the diagnosis. I often edit this line and I use this line to put in a few words such as pertinent findings or plan and use this as a cheat sheet to see the whole chart on one page. I can then easily find a note I want to reference or a test I want to review again. I can refresh my memory in seconds about the patient s history and problems. Letters back to referring doctors can be done automatically as you exit the patient chart. It saves a lot of time not having to dictate as separate cover letter. Praxis grows with your knowledge, and learns just as fast as you do! The Concept Processor is nothing short of amazing. One of a kind Concept Processor Office procedure documentation is a breeze with Praxis. While there are similarities between each ENT procedure each one is also unique. Praxis shines in this scenario and makes documenting the procedure fast and easy. I do it on the fly and the note is done as the patient leaves the room. Praxis can be set up to help you remember important questions to ask on certain chief complaints. However, you are not stuck asking only those and do not have to ask all if they do not pertain. It is easy to add to the history taking section as you expand your knowledge on a subject and want to add that to your current set of history questions. It is as easy as adding the question and pressing save and the next the next time you choose that assessment, the question will be there. Praxis grows with your knowledge, and learns just as fast as you do! The Concept Processor is nothing short of amazing. I recovered my investment immediately So far I have saved 500% in the first year alone as my office is so much more efficient than it was previously.

7 Unrivalled Return on Investment I recovered my investment immediately. I went from a staff of seven: five full time and two part time, to a staff of three. I have saved the money from the salaries and benefits of four employees. I do not need a filing clerk or transcriptionist. I see patients a week, 30% more in the same amount of time than I was previously seeing, and I operate 2 days a week. My medical assistant can keep on tasks and call backs as they are effortless remember. So far I have saved 500% in the first year alone as my office is so much more efficient than it was previously. My accounts receivable at 90+ days is less than 15%. It is simply incredible! The insurance company will try to deny everything, and we appeal every denial. With Praxis, the chart is readily available for notes and review for these appeals. I can only think of 5 or so claims that we have not won our appeal on. More beneficial dealings with third parties We are aggressive at working insurance denials. The insurance companies will try to deny everything, and we appeal every denial. With Praxis, the chart as I wrote it in my own words is readily available for notes and review for these appeals. I can only think of 5 or so claims that we have not won our appeal on this year and most of them are surgical claims that the insurance is denying. Final Thoughts Praxis means better care for the patients, in a cost and time efficient manner; it means better medicine for everyone, patient and doctor alike. I think this product is exceptional. I have used the very expensive mainstream EMR systems and they do not compare. It is priced so that even the solo practitioner can afford the product. Praxis means better care for the patients, in a cost and time efficient manner; it means better medicine for everyone, patient and doctor alike. I do not spend hours working on charts and my notes are more detailed as I am doing them all real time and remember nuisances and data that I want to include in the note. I can see more patients in my allotted time and they feel like they are getting better care as my notes are more detailed. I spend less time reviewing notes and dictations and can get home to my family more quickly. I think this product is exceptional. I have used the very expensive mainstream EMR systems and they do not compare. It is priced so that even the solo practitioner can afford the product.