Nephrology Case Study

Praxis EMR: Nephrology Customer Focus Study

PHYSICIAN PROFILE

Name:

Pablo F. Ruiz-Ramon, MD (Associate Clinical Professor, University of Florida)

Clinic:

Tampa Renal Physicians, a four provider single-specialty group in Nephrology. Based at two clinic locations in Tampa and Brandon, Florida.

Background:

Dr Ruiz-Ramon has been a clinician for more than 25 years, initially in Internal Medicine and subsequently in General and Transplant Nephrology. He left a multi-specialty multi-organ transplant practice to start a single specialty Nephrology practice in 2004 and was certain that the 'cookie cutter' menu-based template EMR in use at his previous clinic was not for him. After much research, he decided that Praxis could offer an extremely flexible EMR-based clinical documentation solution that made sense. He opened his office with a fully paperless system, which remains the reality today… no charts, no stacks of 'to be reviewed' labs, and no piles of strewn about messages on his desk... and no templates!

"Praxis is far from the static alternative offered by template EMRs. Praxis grows with you and becomes an extension of your new knowledge"

EMR choice - Decision for Praxis

Why EMR?

"I implemented an EMR for numerous reasons including ease of recording and storing chart information, efficiency with filling prescriptions, avoidance of time inefficient repetitive dictation (i.e. repeating the same lengthy list of multiple medications each time), sharing of legible and educational notes with colleagues, legal protection, eventual cost savings and revenue increase, and knowledge of upcoming federal reimbursement 'coercions'."

Why Praxis?

"I chose Praxis for the following reasons, which essentially revolve around the fact that Praxis was the only non-template EMR on the market:

• No unalterable drop down menus.
• The ability to give my name to any diagnosis, not the ICD-10 code name chosen by a bureaucrat that you find in rigid template systems (Yet I can still link my diagnoses to recognized ICD-10 codes).
• The finished note looks like I dictated it, not like an unintelligible morass of half sentences, because Praxis avoids template 'structured language' in favor of intelligently re-using my own particular words and phrases.
• Praxis makes it easy to change and save a note for any diagnosis based on newly published studies, clinical practice guidelines and observations.

"The finished note looks like I dictated it, not like an unintelligible morass of half sentences"

Dr Ruiz-Ramon's Praxis EMR Advantages

A Flexible, Non-Template EMR

"Praxis is far from the static alternative offered by template EMRs. Praxis grows with you and becomes an extension of your new knowledge. I'm no longer the same physician practicing in 2004, and neither is my EMR."

A Vital Aid to Expanding Your Clinic

"When adding new providers to the clinic, the time investment is incrementally lower when existing assessments and plans can be shared and then customized, as is the case with Praxis EMR. Praxis also allows the members of our group to learn from each other, thus using everyone's strengths to achieve excellence in patient care."

"Praxis also allows the members of our group to learn from each other, thus using everyone's strengths to achieve excellence in patient care"

Praxis EMR: Your Second Medical Brain

"I don't forget to order a test or counsel my patient about issues relevant to their medical problem. With Praxis, it's like having an extra brain working for you that is unfazed by the numerous distractions of a busy medical office."

Thorough Notes for Your Referring Physicians

"Praxis allows me to provide detailed information about any particular clinical problem to my referring physicians, an impossibility with dictation or menu-based template EMRs. My referring physicians say, 'Of all the notes I get, I like yours the most'."

"With Praxis, it's like having an extra brain working for you that is unfazed by the numerous distractions of a busy medical office"

Complex Nephrology Cases Handled With Ease

"Nephrology patients are extremely complex and not only do they have multiple medical problems, but the presence of kidney disease in and of itself begets problems with other organ systems; for example anemia, hypertension, hyperparathyroidism, metabolic acidosis, etc. Praxis, as created by me, reminds me to address all of these issues when I see a patient with kidney disease. I can also mention in my assessment for each of these issues whether normally accepted goals (i.e. KDOQI) are being met."

"Nephrology patients are extremely complex... the presence of kidney disease in and of itself begets problems with other organ systems... Praxis, as created by me, reminds me to address all of these issues"

Dr Ruiz-Ramon's Final Thoughts on Praxis EMR

"Praxis EMR is allowing me, with great ease and confidence, to provide thoughtful and complete medical care to a highly complex patient population while at the same time keeping my referring physicians well informed about their patients and well educated about their patients' medical diagnoses.

"My old system would never have performed with such ease and simplicity."

"With time and the added help of my energetic, young, computer-age partners (and Praxis support), I hope to soon achieve my vision of the perfect Nephrology practice."

"Praxis EMR is allowing me, with great ease and confidence, to provide thoughtful and complete medical care to a highly complex patient population"