Pain management / Anesthesiology Case Study

"That flexibility provides a lot more ease when you have multiple physicians and multiple users in the same practice, and not everyone agrees on using the EMR in the same way. This flexibility allows you to use it the way you want to use it."

I have a conventional pain management practice and my primary specialty is anesthesiology. I have a subspecialty and further training and board certification in pain management as well.

Anesthesiology requires very patient-specific doses of different medications to perform surgery and other procedures. Pain Management focuses primarily on the origin and treatment of localized pain or injuries. Praxis was the first choice for me as an anesthesiologist & pain management specialist because my field is so specialized. With Praxis all of my chronic diagnoses are handled automatically for each patient and it is easy monitor the progress of my patients and their specific needs. Praxis has learned what my typical cases are, so it lets me finish long and complex charts in minutes.

What made you choose Praxis?

In my practice I have five full time medical assistants, one nurse practitioner, and two doctors. We started using Praxis in 2008, at the beginning of our practice.

I did quite a bit of research on EMRs and we did trials for a few of them. Praxis has a web tutorial that shows how it is different and not bound by templates. I had worked with template EHRs in before, and it was very difficult to have them behave the way you wanted them to. I went to a few of my friends and they pointed out that Praxis sounded like a better option. We chose Praxis and we have been very happy.

Walk through a typical case using Praxis.

There are three types of patients that we see – new patients that come in for the first time, recurrent or follow-up visits, and procedure patients. When the new patients come in, we have medical assistants who take their brief, enter it into the chart, and forward that to us. With the help of Praxis trainers, I created a basic layout that makes it very easy for me when I see the patient, because it is based on my specialty. I can either add the patient’s history of complaint, their physical examination, and their proposed plan, or I can dictate it, send it as a transcription and my medical assistant can input that information.

Praxis makes this easy because as a specialist, I often have similar instructions for pain patients and similar descriptions for how pain starts. I have created these descriptions over time and I have put in other instructions with my notes. This means that even if I dictate a note, my medical assistant just has to select this text and add changes, rather than typing it as with any other EMR. This is why we’ve never had to use any transcription service or dictation software. The flexibility of Praxis means I can dictate or I can type myself, and it never takes very long.

Praxis has the most value when we see return visits. Return visits are extremely simple – we have everything in the system already set up, so all I have to do is to write down changes. Everything else that is required for the level of visit is displayed perfectly already, which saves a lot of time. That means I can spend more time with the patient rather than charting.

What do you like most about Praxis?

The thing I like most about it is the easy access. When you open up a patient’s chart, it’s not displayed in small boxes that you have to open one by one to look for past medical history or physical history, and then put everything in different words. All the information is right there, like a simple straight paper chart, and you can scroll up and down to see it.

Then there’s the flexibility of however you want to use it – some people do want to use it with templates set up, and they can do that with Praxis. But if you want to use it smartly, since it gets smarter as you use it, you can do that.

That flexibility provides a lot more ease when you have multiple physicians and multiple users in the same practice, and not everyone agrees on using the EMR in the same way. This flexibility allows you to use it the way you want to use it.

Does Praxis save you time?

If I were to type all of my follow-up visits with any other EMR, it would probably take me an hour and a half to two hours to do my notes every day, if not more. With Praxis I can get it done while I am seeing a patient, so when they leave the room my note is done for the follow-up.

What would you say about Praxis to other pain medicine specialists?

When I started with Praxis, the system was blank, so I could draw it up and make it as I wanted it to be for myself. In other words, you don’t have to be stuck with someone else’s examination or procedure notes; you can create them just as you want it to be.

Now, friends of mine, even my brother, have opened up practices and use Praxis as well. I realized that for them it was even easier, because they could use my knowledge base as well – they could build their own, not from scratch, but using all my work and knowledge base to start with. Then they could make their own changes as they went along. It makes the procedures, assessment of new patients, and follow-ups really a no-brainer.

Do you use Praxis for Meaningful Use?

I attested for Meaningful Use with Praxis. The reimbursements that I have received cover the cost for the EMR and more. That in itself is a big advantage. There’s also comfort in the fact that when Praxis makes changes to the EMR to accommodate new legal changes, at the same time, it stays functional.

How have your experiences with customer support been?

That’s the best part about Praxis. With other software, it can be hard to get help as a small practice. With Praxis, it is very easy and convenient to chat, email, or call and get somebody to take care of it. Any time we have any issues or concerns we can get somebody to look at the problem. Knowing the urgency, they will have somebody take care of it right away.