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Middlebury Specialist Achieves Meaningful Use

If anyone thinks achieving meaningful use needs to be a long process, they should talk to Todd Lefkoe, MD, the owner of Vermont Spineworks and Rehabilitation in Middlebury. Just nine months after going live with his Greenway EHR, the specialist physician met all the criteria for meaningful use and had filed for his first Medicare EHR incentive payment.

Lefkoe had been employed by Rutland Regional Medical Center, but decided to leave that position to open his own practice in Middlebury to treat spine, muscle, nerve and joint problems. Because he was starting his practice from scratch, he had no legacy paper charts to deal with.

“I had a chance to take a fresh sheet of paper and design things from the ground up. And that included starting right off the bat with an EHR,” Lefkoe says.

The other thing he did from the start was hire VITL to help him with the health information technology. “VITL provided assistance to me in weighing the various options in choosing an EHR and negotiating with the EHR company,” Lefkoe says.

Accurate Data Collection 

Priscilla Phelps, a VITL implementation specialist with a background in physician practice management, was assigned to work one-on-one with Lefkoe. “I think she helped me to think about practicing in a new and different way by emphasizing the importance of accurate data collection and making sure that whatever system that I was going to go with would be able to provide me with meaningful information   -- meaningful statistics about my practice, about my practice patterns, about the patients that I see. “

“Being able to build in mechanisms for capturing data that was relevant to the practice and meaningful use goals was important,” says Phelps.

As Lefkoe began looking at recorded demonstrations of various EHR systems – available on VITL’s website – he kept in mind Phelps’s advice about choosing a system. “She emphasized the importance of the decision and the fact that perhaps no other decision that I would make would affect my day-to-day practice life as much as the decision of which EHR to choose. She encouraged me to ask many questions, to get a feel for note creation, ease of documentation and the ease of electronic navigation,” he says.

EHR selection is a very personal choice, Phelps says. What appeals to one provider may be the same thing that is a deal breaker for another. She wanted to ensure Lefkoe selected an EHR that would meet his specialty needs and accurately document the procedures and types of office visits he performs. “I provided Todd with information on how to evaluate demos and local references for the products he was interested in purchasing,” she says. “On the flip side, Todd did his homework.  If I suggested he spend time doing something, he did and that contributed greatly to the project.”

Contract Negotiation Assistance

After Lefkoe decided to enter into negotiations with Greenway, Phelps spent several hours combing through the contract that the company offered and providing feedback, including potential language changes.

Lefkoe believes he received a better deal from the EHR vendor with VITL’s help than what he would have gotten on his own. Specifically, VITL helped him get much more training time included in the deal than what the vendor originally proposed. That extra training helped make the go-live much smoother, he adds. “I don’t think that I could have advocated (for additional training) as strongly as I did without VITL’s help.”

Meaningful Use Dashboard

As he prepared to achieve meaningful use under the federal EHR incentive program, Lefkoe again drew upon Phelps’s expertise. She assisted with setting up the EHR’s meaningful use dashboard, so that Lefkoe could monitor his progress, and conducted a security risk analysis. “With the good support and education provided by VITL, and a willingness to remain flexible in my day-to-day practice patterns, I think I was able to adapt fairly quickly to track the data and to practice in a way that fulfills the requirements,” he says.

Now that he’s achieved Stage 1 of meaningful use, Lefkoe says he’ll continue relying on Phelps and VITL for help as questions arise. “I remain very optimistic about medical practice in the future and the ways that electronic health records systems can aid that practice,” he says. “I can certainly count on many things changing over that time, and it is good to know that VITL will continue to be here as a resource to help me negotiate those changes."