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How a Solo Physician Aced Stage 1 Meaningful Use

Joe Cantlupe, for HealthLeaders Media, August 18, 2011


Golden says he's attracting younger patients, which he attributes to EMRs.  "I have beautiful records," he says, laughing.

Golden, has been in practice 24 years as an internist, specializing in cardiology and bariatrics. An electronic dashboard system that measures his  practice's meaningful use progress by collating and tracking data, has made the work much more efficient, he says. Patients are enjoying the "instant interaction and the connection they now have with us," he says. "With instant access to their records, they are taking greater ownership of their care."

"I realize this kind of stuff is going to allows healthcare to function at a lower cost in the future with respect to patient management issues," Golden says.

When Golden switched to EMR, he stopped paying the monthly rate for a storage facility for the paper records. Still, the process took months. "Most of our staff didn't help us out when it came to the scanning of the documents," Golden says. "That was mostly done with family members, and a couple of college students that we hired. It was labor-intensive for nine months. My wife and I were in the office scanning shots on Sunday."

In the meantime, CMS surprised him with an audit of Medicare patient visit codes. The paper and the electronic medical record transition appeared to confuse a CMS review, in Golden's view, leading to what he called a "funny" interaction with the agency. Still, Golden believes the electronic recordkeeping enabled him to "survive the audit."

"It was really interesting. We were audited right after we started with our electronic (records) and they requested 24 charts from one day's (work) at our office," Golden says. "Out of the 24 charts, three were paper charts. They automatically approved (the paper charts), and they automatically rejected the electronic charts, it was really funny."

"A reviewer at CMS didn't recognize the electronic signature was valid," Golden says. "Once a supervisor overruled her, they accepted everything. It was kind of comical. Eventually, we passed (the audit) with flying colors after they recognized an electronic signature made sure it was a valid one,"

"I think one of the reasons why we survived the audit without a glitch was because I had legible records."

That transition to EMR has increased payments from CMS, Golden says. "We've been getting the e-prescribing checks. Of course, I expect to get paid the $18,000 for the stimulus money, so a lot of these dollars that came back to us we would never have received had we not gone with the electronic system," Golden says.

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