Dermasurgery and Mohs Surgery Case Study

"Like many physicians I was becoming increasingly disenchanted with the practice of medicine, but with Praxis easing my stress and frustrations, I again look forward to going into the office every day."


EMR Decision

Why use an EMR?

My practice had always used dictation since hand written notes are too slow and often incomplete, as well as an in-house transcriber because outside transcription was either too slow and/or too inaccurate for dermatology. We then switched to voice recognition software to decrease costs. I was becoming awfully frustrated with dictating the same things over and over. Even with using macros and personally made templates the quality of my records was not satisfactory and I thought I was spending far too much time on record-keeping. I was becoming increasingly irritated by misplaced charts and the inherent inefficiencies of running a paper-based practice. With Praxis, my practice is now paper-less.

"I will see 40-60 patients daily, [...] and need a system that can keep up with my practice... I have been very pleased with how Praxis has been able to accomplish this."


Decision for Praxis

I will see 40-60 patients daily depending on the number of surgeries, and need a system that can keep up with my practice. I investigated 20-30 EMR’s before deciding on Praxis. Others left notes that obviously looked like they were generated from templates, or could not handle the graphics requirements necessary for dermatology. I delayed implementing Praxis until it could handle the graphics needed for dermatology including documenting pictorially locations of biopsy sites, locations of treated lesions and photographic documentation. I have been very pleased at how well Praxis has been able to accomplish this. It is great to be able to pull up a photo of a patient's mole on my pen tablet while seeing a patient to see if it has changed since the last visit. Physicians who refer patients to me for Mohs surgery have been impressed with the quality of my referral letters and that they arrive by fax the same day I see the patient.

"With Praxis, I can rapidly and comprehensively document a patient who complains of actinic keratoses, seborrheic dermatitis, rosacea and needs 2 biopsies to rule out skin cancer within a few minutes".

The Advantages of Praxis for Dermasurgery and Mohs Surgery

Unrivalled streamlined, comprehensive and customized patient automation

I can now quickly fine tune the history taken by my medical assistants, rather than spending an inordinate amount of time asking all the history questions myself. No lost or missing charts. No delayed review of lab results or prescription refill requests as it is all automated and available to me as soon as they arrive in the office. With Praxis, I can rapidly and comprehensively document a patient who complains of actinic keratoses, seborrheic dermatitis, rosacea and needs 2 biopsies to rule out skin cancer within a few minutes. The documentation will include diagrams of the actinic keratoses treatment sites and biopsy sites, the location of previous biopsy sites, a form/label will print out to slap on the biopsy bottle, prescriptions will print out and the documentation to justify the level of coding will be automatically present. I used to routinely undercode because even though I provided the service, the documentation to justify it became too onerous to routinely include in the note. With Praxis, documentation is no longer an arduous job, but a task I thoroughly enjoy doing.

"I used to routinely undercode… because the documentation to justify it became too onerous... With Praxis, documentation is no longer an arduous job, but a task I thoroughly enjoy doing."


Better quality staff training

Training new medical assistants has now been made much easier by Praxis as procedure set up instructions automatically appear before them when they bring the patient into the exam room. It doesn’t stop there - we recently invited a new physician to join our practice. The Knowledge Exchanger will allow him to much more rapidly document his patient visits accurately and blend in to our practice style.

"Agents", the incomparable more-than-just-a-memo system

I'm sure you've heard how Praxis’ built-in memo system, “Agents,” is far more than just a memo system and greatly improves communication and efficiency in the office. One of its abilities that I find very helpful is that a reminder message will automatically pop up at predetermined times. For instance if I open a patient's chart to enter a pathology report, when I read the biopsy slide a window will pop up reminding me to call the patient with the results since for whatever reason this particular patient isn't returning for a follow-up visit. I can also have a window pop up when I open the chart for a patient visit reminding me to check a spot I noted on the last visit to see if it should be biopsied, or that the patient’s spouse died the previous month or any other reminder I want to see, but don't necessarily want to document in the chart.

"No question that my reimbursements have increased as I now properly code for visits instead of routinely undercoding…Using Praxis is not only more cost effective for me, but also easy to use


More reimbursements

No question that my reimbursements have increased as I now properly code for visits instead of routinely undercoding. I can easily do this because of the automatic documentation from Praxis that requires no extra time or effort from me. Using Praxis is not only more cost-effective for me, but also easy to use.

Final Thoughts

I could not be more satisfied with Praxis EMR. There are innumerable ways large and small that Praxis has made practicing medicine easier, more efficient and many a time pleasurable for both my staff and myself. Like many physicians I was becoming increasingly disenchanted with the practice of medicine, but with Praxis easing my stress and frustrations, I again look forward to going into the office every day.

"There are innumerable ways large and small that Praxis has made practicing medicine easier, more efficient and many a time pleasurable for both my staff and myself".

Praxis Electronic Medical Records (EMR) - Dermasurgery and Mohs Surgery Case Study

Physician Profile

Name:
David H. Friedman, M.D.

Specialty:
Dermatology, Dermasurgery, Mohs Surgery

Clinic:
Northridge Dermatology Associates

Location:
Northridge (Los Angeles), CA

Background:
Dr. Friedman has been in private practice in Northridge since 1985. He trained at the UCLA Medical School, completed his dermatology residency at Harbor-UCLA, and serves as a Clinical Professor of Dermatology at USC, as well as a Clinical Associate Professor of Medicine/Dermatology at UCLA. Dr. Friedman began using Praxis full-time with patients in 2005.

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