Case Study: Growing Locations and Standarizing Care with DocuTAP EMR and PM
14 clinic locations
2 joint ventures with Memorial Health
Opened in 2004
170 staff members
15 management staff
30-100 patients per day per clinic
Acute Primary Care
Workers’ Compensation Visits
Uses full DocuTAP platform, which includes:
- Electronic Medical Records (EMR)
- Practice Management (PM)
- Patient Engagement (Clockwise.MD)
- Consulting Services
- DocuTAP Analytics
DocuTAP Customer Since:
AppleCare Immediate Care was experiencing growth, but was held back with their previous EMR, which couldn’t handle their needs. Their previous system had no easy way to edit options or set permission levels, so standardization of care was a constant issue. With DocuTAP, AppleCare now has set templates and the control to grow clinic locations without confusion.
AppleCare Immediate Care was founded in 2004 in Brunswick, GA by orthopedic surgeon Dr. Melvin Deese. AppleCare is a one-state, private investor-held immediate care serving patients in middle and southern Georgia. AppleCare provides a wide range of services at their current fourteen walk-in locations. Services include urgent care, occupational medicine, and workers’ compensation visits—and patient age ranges served include six months and up.
In 2011, Dr. Deese partnered with Med Equity and Greenridge Investment Partners. This partnership has provided AppleCare with additional leadership, infrastructure, and financial support. Since this partnership, AppleCare has more than quadrupled clinic locations in four years. In 2014, AppleCare entered into a joint venture partnership with Memorial Health to manage urgent care and occupational medicine services for the health system. AppleCare now operates several clinic locations in this partnership.
AppleCare Immediate Care’s desire for growth was prohibited by their former EMR. Their previous EMR was not focused toward urgent care in design—and didn’t have the flexibility to set user permission levels. Nor did it have the ability to edit for provider preference.
No standardization of care existed across clinic locations—or even from provider to provider. This caused “mass confusion,” said clinic administrator Paige Spell. Varied and inconsistent documentation meant patient and procedure information went missing or wasn’t documented correctly.
The direct consequence was incorrect billing codes, making correct reimbursement impossible. Billing “was a nightmare” lamented Spell. Not being able to control elements within the EMR, coupled with the need to quickly grow locations after acquisition, lead to AppleCare’s decision to switch EMRs to one that fit their immediate care.
Solution / Approach
AppleCare Immediate Care knew what it needed in an EMR—scalability, customization, and the ability to set documentation standards. Reviewing options, AppleCare visited DocuTAP partner American Family Care in Birmingham, AL. After their on-site visit, they knew DocuTAP’s urgent care-specific EMR fit their needs.
“DocuTAP was easy to maneuver,” Spell praises. “It’s just like a paper chart with the chief complaint, vitals, and medical history. It is an easy transition from those using paper.” Another key feature that AppleCare appreciated was reporting capabilities in DocuTAP. “There’s every type of report and then some, and DocuTAP Analytics is available for anything else,” noted Spell.
“DocuTAP was easy to maneuver. It’s just like a paper chart with the chief complaint, vitals, and medical history. It is an easy transition from those using paper.”
— Paige Spell, Clinic Administrator
Spell also loves that DocuTAP EMR and PM software is consistently updated with new features and enhancements. “My voice is heard when I suggest changes and improvements to DocuTAP. That means a lot, that they listen to me,” Spell continues—having come from using a generic, national-based EMR with less personalized service.
With DocuTAP, AppleCare has standardized care, reduced wait times, improved chart documentation, and now reach correct E/M codes—passing internal chart audits with flying colors. Here are some of the improvements they have seen:
Ease of Implementation & Workflow Efficiencies
As a larger urgent care, AppleCare knew it needed a good game plan for successful implementation of DocuTAP across its then 10 locations. AppleCare took a phased approach to implementation, launching their new EMR with the help of super users who would stay with each clinic location during their go-live—and several days after—to help the staff feel comfortable with DocuTAP. Spell shares that the implementation training they received helped make them independent of DocuTAP during launch.
Even now, after being on DocuTAP for several years, AppleCare continues to refine its implementation process as it opens new clinics. They train staff first at an existing location before moving on to a new clinic location. This helps staff have an easier transition.
AppleCare has noticed a definite increase in efficiencies since switching from their generic EMR to urgent care-based DocuTAP. Wait times have dropped by 15 to 30 minutes per visit. Charting times have also improved, cutting documentation by an average of 20 minutes a chart. In addition, Spell notes that staff are locking charts—and leaving work on time, which didn’t happen before.
Best of all, internal chart audits prove that with DocuTAP, providers are reaching the correct documentation level to accurately reflect chosen E/M codes. This means AppleCare is receiving timely, correct reimbursements for the services they provide. Spell shares, “Providers can see what areas they have missed with the red mark reminders in the EMR before locking the chart.”
“The tab system in DocuTAP is nice for navigating back to areas needing more detail,” she continues. Before, because of the poor layout of their previous EMR, important details like allergies, social history, and vitals would often be missed. Happily with DocuTAP, AppleCare is now enjoying complete documentation—and 100% of providers participating in Meaningful Use have successfully attested using DocuTAP.
Standardized Documentation & Scalability
One of the biggest challenges AppleCare faced with their previous EMR was a lack of standardization. No user control settings existed, so templates didn’t have a standard base of information. With DocuTAP, AppleCare can choose who has specific permissions—and can set template standards to a specific provider, or even by location if desired.
Now, AppleCare can grow locations with confidence, knowing that documentation and reimbursements are consistent. Spell names top benefits of DocuTAP being “complete charts, easy to document, staff entering correct info, streamlined coding, and fewer procedures missed. DocuTAP is very easy to navigate, and given time to learn it, the staff is faster with DocuTAP than with their previous EMR,” adds Spell. She also shares providers’ favorite thing about DocuTAP is coding support—while management likes the customization options.
Spell goes on to explain how they love ePrescribing, which has removed the hassle of print-pad prescribing. They also appreciate their lab interface which pulls results directly back into the EMR, removing the paperwork requests and scanning back in of results.
AppleCare’s recent joint ventures with a health system means their future is bright for partnership growth. They also plan to open several locations each year, says Spell, so a scalable EMR is perfect for the immediate care’s goals. Interfaces with DocuTAP have also helped AppleCare streamline enterprise-focused goals and growth.
Super User Certification Participation
In addition to implementation training, AppleCare has taken the progressive step of attending DocuTAP’s Super User Certification classes. Becoming Certified Super Users has allowed them to accomplish software goals internally rather than having to utilize DocuTAP staff. They also wanted to grow quickly and independently, by training their own staff with super users.
Attending Super User Certification, AppleCare staff also enjoyed learning about future releases in the software—along with tool options they hadn’t taken advantage of yet—like DocuTAP Analytics and the Secure Patient Portal.
“The training was excellent, and I came away with a better understanding of the system as a whole—how it’s all connected,” adds Spell. “We learned how to set security measures in place and legalities for MU participation.” She also learned about DocuTAP specific features like quick workflow initiators (QWIs), which she says are “really good”. She is excited to apply them in all AppleCare clinics.
On-site training has been altered at AppleCare to reflect things learned at Super User Certification. Learning the EMR and PM is assigned out 90 days in advance of start dates, and staff are encouraged to learn on the job. Tips and shortcuts super users learned are also taught to new staff. AppleCare is implementing occupational medicine protocols—and will be using DocuTAP Analytics in the future. “I’d absolutely recommend certification,” furthers Spell.
AppleCare is pleased about their decision to switch to DocuTAP. Spell shares, “DocuTAP staff is super friendly, helpful, and knowledgeable. As a whole, the company is very personable.”
Growth potential lies in AppleCare Immediate Care’s near future. Spell says other joint ventures with health systems or affiliates aren’t out of the question—but they plan to grow individual clinics as a first priority. “Our goal is to open two to three AppleCare clinics a year,” Spell concludes. With DocuTAP’s standardization and scalability, there’s no doubt AppleCare will achieve and surpass these goals.
Explore Products & Services