You've heard the old adage that "necessity is the mother of invention." That's definitely the case with Exscribe EHR, an electronic health records system developed by Dr. Ranjan Sachdev, a nationally-renowned orthopaedic surgeon. Dr. Sachdev led a team of developers to create a system specifically for orthopaedic surgeons to use in practices just like his own.
It all started when Dr. Sachdev was working on his MBA. He expressed a desire to improve the business of medicine, and his professor challenged him to work on ways to improve efficiency in his own practice. While searching for a method to help meet this goal, he remembers finding the options "woefully inadequate," and the process of creating Exscribe began.
Dr. Sachdev believed that for the system to be successful, the technology needed to match the way each physician practiced, instead of expecting physicians to change the way they practiced to meet the technology. And being a physician himself, Dr. Sachdev knew from the start that for physicians to want to use this product, it had to be flexible. He understood that physicians are very independent professionals—if there are six physicians in one practice, they will likely practice medicine six different ways. Exscribe EHR was developed to meet the demands of all of them.
The Exscribe system uses a rare combination of standardization and flexibility. The standardization of procedures in Exscribe allows for quickness, accuracy, and efficiency. But the flexibility allows physicians to customize the data recorded to meet their own needs. Dr. Sachdev explains, "For example, if you want to dictate the history of how the patient got hurt, you can do that. It's very hard to template how the patient fell and where they fell. That part is easier to dictate. However, the examination is fairly standard, so that can be templated. And there the template has the advantage, so you don't forget to examine anything."
Because development of Exscribe EHR is continual, an exciting new feature will be available soon that will provide a tremendous benefit to orthopaedic practices. A new Medicare payment reform program, MACRA, is an incentive payment system where physicians will be evaluated on data collected beginning in January of 2017—right around the corner!
Based on the data collected, physicians will begin receiving either a bonus payment or incurring a penalty. It’s revenue neutral, meaning that money for this program will be taken from the more underperforming physicians and given to the higher-performing ones. Part of the determining data will be found in electronic or health records that Exscribe can provide. Another determining factor will be evaluating what physicians have done to improve their practice—physicians who have implemented Exscribe EHR will again benefit.
The MARCA program is basically a shift toward quality measures, and Exscribe will help physicians be rewarded. Those using Exscribe will have a system in place that will help them score as high performers. This benefit is going to have enormous appeal to orthopaedic practices!
As Dr. Sachdev works to continually update and improve Exscribe, he is also still a practicing orthopaedic surgeon. Both take an incredible amount of work, but Dr. Sachdev credits his team and the people around him for his success.
"It's an example of being lucky and having good people helping you. I have really good people at the company. They are dedicated and very smart. Having good people working with you–that's really the main thing."