Alliance Spine and Pain Centers

The Client

Alliance Spine and Pain Centers focuses on non-surgical treatments for spine pain. Alliance has 14 outpatient surgical facilities approved by the Joint Commission on Accreditation of Healthcare Organization where they offer state of the art modalities to help manage their patients pain. Alliance focuses on comprehensive care to fix the root problem behind patient’s pain, and have 19 locations, 24 Physicians, 19 Mid-Levels, and 25 CRNAs. Several of Alliance’s physicians received the Atlanta Magazine’s “Top Doctors” honor in 2018.

The Situation

Alliance Spine and Pain Centers implemented eClinicalWorks in 2006 with one physician and grew from one location to 19 locations quickly. Their rapid growth needed many functionalities that eClinicalWorks did not offer at the time. The practice developed workarounds to address their needs, which as eClinicalWorks developed new functionalities, began to become problematic.

The practice’s previous internal eClinicalWorks Expert moved into another role. A new eClinicalWorks Super User was appointed and we contracted with Curas to provide the Super User Training. During the Super User Training Sessions, it became abundantly clear that most of the practice’s workarounds that had been utilized were no longer required due to new software development. We then had to decide how to move forward with the no-longer necessary work arounds, which lost their customization with every eClinicalWorks update. Upon additional consultation with Curas, the decision was made to rebuild the EMR system.

The Client’s Need

The practice had workarounds specifically to handle clinic, surgical, and ASA operations. The scheduling set up and processes needed to be reconfigured as the practice scheduled by Resource, which was the Facility, and by Visit Type. Provider reporting was challenging at best, and providers were unable to view their individual schedules.

The practice also needed to establish a consistency of workflow documentation across all of their centers. Aiding the staff’s ability to find the necessary documentation to improve the precertification process; thus allowing our patients quicker access to care.

How Curas Helped

Debby Macikowski with Curas worked with Allison Smith to completely restructure eClinicalWorks to create a Standard of Care for all of Alliance’s Clinics and ASCs. This ensured that they would have all the functionality they needed, including better documentation and reporting processes, as well as a new way to schedule. Curas first started with cleaning up and rebuilding the existing database and redefining workflows for consistency.

Three physicians, Dr. Hord, Dr. Marshall and Dr. Gale, were appointed to champion the project and help define how the documentation would be captured in order to make clinical sense and be reportable. A main focus was to track Patient Quality Metrics specific to each patient. This involves the provider asking the patient to create a functional goal for their next visit, at which their progress can be tracked through quantitative scoring. For patients who are receiving long-term care for chronic spine and pain issues, this is very helpful to track what improvements have been made in the patient’s quality of life.

Revamping a healthcare system which has been around for a number of years while it is still in use isn’t a simple process, and involved setting up domains for redevelopment, testing, training, and transitioning over. It’s important to note, that the EMR redesign and rebuild was done without impact to our daily operations. Another large and integral piece of the transition process was training the faculty and staff on how to use the newly redesigned EMR system and provide documentation for the new processes.
Curas worked with Alliance’s new eClinicalWorks Super User to create Training Manuals with straight-forward step by step instructions for each department. The first training session was for regional administrators and a chosen representative from each location, followed by a second training with their teams. Four all-day training sessions were provided, and staff were welcome to attend more than one training session. Training manuals were distributed to all attendees.

The Results

Changing how the schedule and visits are set up has made a significant positive impact in both patient wait times and providing the Medical Assistants adequate time to capture data in a consistant, timely, and accurate manner. Quality measures are now built into the system, and structured data can now be reported on. The practice has realized a decrease in Pre-Certification denials for procedures, which means patients are able to obtain the treatment needed in a timely manner. Progress notes are now documented in a uniform way, which makes it easy to mine information, and the custom drug database has been cleaned up saving time searching for the desired medication and dose.

The EMR Optimization has prepared Alliance for the eClinicalWorks ASC Module which will only further increase the practice’s efficiency and utilization of eClinicalWorks functionality.

“We chose Curas because of our long-standing relationship with our Account Manager, Debby Macikowski. With our Super User’s clinical knowledge and Debby’s software and operations knowledge they were able to strategically work through each challenge. The Curas team was always available for a call to work to a solution, and we appreciated Num keeping us informed of new functionality and how Curas could help us leverage these updates.

One of the things we respect Debby for is that she is not afraid to tell us if we were going down the wrong path and offer better alternatives. We were always confident in Debby’s understanding of our situation and the best ways to move forward. We can highly recommend Debby and the Curas Team without reservation.”

Spencer Scarbrough, Vice President of Operations.