By Dr. Patrick Golden


I have been practicing medicine in the Fresno, Calif. area for 24 years. In that time, I have experienced a few different ways of running my solo practice and gone from typewriters to computers, and from phone and fax to e-mail. Recently, my staff and I steered the practice through Stage 1 Meaningful Use attestation and it was a success.

From the very day I heard of meaningful use, I knew we (the practice) were going to work towards attestation. However, we didn’t need to change much of the practice and our usual activities because we were already doing most of the things required under the program. The two major changes we made were beginning to issue patient visit summaries and using the patient portal to engage patients.

The program’s requirement of having a portal for patients to engage their care providers has changed the way we deliver health care. Our patients are very impressed with the portal and its capabilities and are more engaged in their care. Prior to our EHR implementation, patients were sending e-mails and communicating with us in a much less efficient and secure manner. The portal has simplified communication with our patients and improved efficiencies for all of us. Patients are more engaged in their care because of the portal’s instant interaction and connectivity capabilities. Actually, one of the purposes of the meaningful use program is to help patients engage more fully in their care. With instant access to their records, their labs and most tests, they are taking greater ownership of their care. It’s wonderful to see patients more involved in their care, taking interest, understanding their tests and diagnosis, and saving money by eliminating multiple tests and exams. I’ve had patients who didn’t know they were diagnosed with certain conditions because they weren’t paying attention to their care records. Now, with the portal, EHR, and visit summaries we provide, they are asking more questions, seeking treatment and looking for ways to improve or maintain their health.

Also, meaningful use led us to acquire an EHR solution which has made managing patient care significantly easier. A robust system has been vital to our success. We can measure outcomes, track progress and document care so much more efficiently than when we relied on paper records. Doctors without the software can’t think of everything all the time. We can’t remember the results of every lab test or everyone’s conditions. The system keeps the record in front of us and allows us to streamline and track progress during the patient visit. Why would we ever go back to paper? This is so much more efficient.

Patients can benefit tremendously from meaningful use and EHRs. There’s not one thing in meaningful use that is bad for the patient from a medical standpoint. Meaningful use will help us provide improved health care and become better doctors, and will provide us better processes to achieve it. Patients are getting better care. Doctors are much more likely to manage their care more efficiently. An example of this is when there is a drug recall. All we have to do is pull the information out of the system and notify those on the drug. When we had paper records, this would have been an impossible task.

My advice for those trying to achieve meaningful use is to get people comfortable with your EHR system. Your doctors must be involved in the process from day one. They must be engaged and involved in learning the system and using it for it to be successful. They need to have a vested interest in learning the system. It can be a lot to learn. If possible, try to develop an in-house expert who will manage the technological aspect of the system from implementation to its day-to-day operation. This is a long-term investment and, if conducted properly from the beginning, it can significantly improve the health and viability of your practice, clinically and financially.

Be patient and flexible with the process. You’ll never attest if you don’t remain a bit flexible during the transition. You have to be willing to change and see the positive in Meaningful Use and your EHR. The data we’re now able to track through the system is incredible. That alone has been worth the change.

Dr. Patrick Golden is board certified in internal medicine with specialties in cardiology and bariatrics. He is the sole practitioner for his practice in Fresno, Calif. He is a graduate of the University Of Colorado School Of Medicine and completed his internship and fellowship training through the University of California San Francisco-Fresno Medical Education Program.

Dr. Golden uses Sage Intergy EHR and has recently met the meaningful use criteria and successfully attested to CMS for Stage 1 Meaningful Use of her.