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Expanding a Large Multi-Location Practice - Orthopedic

Meet Jim Griffin
Jim Griffin is the President and COO of Direct Orthopedic Care (DOC), a multi-state orthopedic immediate access clinic. He joined DOC in 2016, spearheading DOC’s formation into a national practice group. The practice group is staffed with board-certified orthopedic surgeons and specialty-trained physician assistants across 9 locations in Dallas Fort Worth, Austin, and Southern California.
Direct Orthopedic Care, or DOC, is a walkin clinic for referral-free, immediate-access orthopedic care. They want to revolutionize orthopedic care by giving patients an “instant care” alternative to the emergency room or an orthopedic specialist. In the next 12 months, DOC is planning on expanding with 16 more offices.

The Business Challenge

DOC had a mission: Provide immediate specialty orthopedic care with a focus on the patient experience.
In some ways, they were succeeding. They had already raised the bar by:
  • Extending their operating hours and staying open 7 days a week
  • Placing their locations in convenient, high-traffic areas (next to coffee shops and grocery stores, rather than middle-of-nowhere healthcare plazas)
  • Cutting out the “middleman” referral process
There was one problem that impacted every aspect of the business: the EHR system was getting in the way. Their initial EHR system negatively impacted and bottle-necked the experience from check-in to locked notes. This detrimentally affected the patient experience and the provider and staff experience at DOC.
The Problems with Their Prior EHR System
Their EHR system was old and complemented by a gigantic paper binder filled with hundreds of pages of clinical workflows and documentation. It had no room for integration with tools that would benefit the practice.
Each new service DOC used required hours of manual work
Reminder systems, analytics, scheduling--these processes required manual operation.
Providers would almost always be taking paperwork home to finish the documentation on the day’s patients. DOC’s already-extended hours of operation made this post-hour work especially taxing.
Checking in patients greatly delayed the patient appointment
It required additional manual effort to:
  • Collect the necessary documents for signing
  • Transfer the physical documents from checkin to the provider for review (prior to seeing the patient)
  • And finally, re-enter the information into the EHR
Patients felt the inefficiency of the EHR too
The patient experience is impacted by having to fill out physical paperwork in the waiting room (especially as so much of their experience, even filing taxes, is now digital).
To top it all off, the patient is interacting with a provider and staff that are likely burnt out from the tedious, unending daily workload.
The issues were apparent, and DOC knew there had to be a better way…
The Solution
DOC knew most of their problems could be fixed by going digital, but they needed to keep operational costs affordable and wanted an EHR powerful enough to make the lives of providers and staffs easier while streamlining the patient experience. A tall order.
DOC needed an easy-to-use, affordable, high-quality, 100% paperless EHR solution.
They found it in DrChrono.
Performance-Enhancing Improvement for Providers and Staf
With DrChrono, DOC was able to completely digitize their intake process, reducing their intake time by 68%.
Then, DOC was able to reduce their workload substantially, to the point where all staff members were able to finish all of their notes before leaving the practice premises. They jumped from “guaranteed to take documentation work home”, to a 96% same-day locked note rate with most notes signed and locked within 30 minutes of clinic closing.
DrChrono EHR cut DOC’s documentation time by 28%. Providers could finish their digital documentation as they finish seeing their patient.
This had two big impacts:
  1. Documentation finished at point-of-care yielded more accurate documentation
  2. Employee satisfaction increased because providers and staff had a more manageable workload when working through the DrChrono EHR
As an extra bonus, DrChrono reduced DOC’s training time by at least 75%. DrChrono is intuitive and easy to use; new team members at DOC could pick up the EHR and intuitively navigate the workflow with little outside instruction. DOC has also seen a dramatic decrease in provider calls to the help desk.
A Noticeable Boost to the Patient Experience
The improved employee satisfaction bleeds into the patient experience. Patients are experiencing more satisfied staff and providers, making for a more pleasant encounter.
DrChrono improves the experience in other ways, too: When patients arrive, they’re no longer tasked with filling out paperwork. Instead, they’re using iPads to check-in. Patients also have the ease of online scheduling.
And from an aesthetic standpoint, they see a wireless office instead of an office cluttered with papers, gigantic binders, and wired desktop computers.
A Highly-Affordable EHR Solution
For their “retail” model to work, DOC needed an affordable total cost of ownership.
Prior to using DrChrono, DOC subscribed to a Transcription service.
Once they switched to DrChrono, they were able to cancel that service and use the savings to pay for their entire DrChrono subscription. DOC had a minimal change in cost and a maximal change in workflow and staff and patient experience. DOC saw their ROI within months of implementation.
Conclusion
With the help of DrChrono, DOC is facilitating major changes in orthopedic care.
They’ve succeeded in implementing their vision of non-referral, immediate-access orthopedic care, and they found an EHR that lets them streamline the clinical process from check-in to locked notes. And they did it while keeping their total cost of ownership lower than any other system they’ve evaluated.
Aside from being the best choice for a high-quality, low-cost EHR system, DrChrono scales as needed.
Even as DOC continues to expand, they have no plans of switching to a new EHR system.
“When we switched to DrChrono, we knew this was going to be our last switch because we’re planning on becoming the largest orthopedic provider in the US, and we know that the platform is built for the future.”
- Jim Griffin, COO and President of Direct Orthopedic Care