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Skyline Family Practice ahead of the health information technology curve

2013_04_24_IT_Doc1.jpg
Tom Christoffel, left, of Front Royal looks at his EKG on a display held by Dr. Floyd “Tripp” Bradd III on a smart phone application during a doctor's visit at Skyline Practice in Front Royal recently. Rich Cooley/Daily

2013_04_24_IT_Doc2.jpg
Skyline Family Practice patient Tom Christoffel scans a QR code from Dr. Floyd “Tripp” Bradd III's phone during a recent office visit. The quick response (QR) codes contain information readable by smart phones that the office uses to share patient information. Rich Cooley/Daily


Correction: The name of Floyd Bradd, founder of Skyline Family Pracitice in Front Royal, was left out of a story on Friday due to an editing error.

By Kim Walter

FRONT ROYAL - The small town known for its rich history and scenic parks is taking the lead on a completely different topic - health information technology.

Who would've thought that the small, three-doctor Skyline Family Practice is actually way ahead of the curve when it comes to things like electronic health records, patient engagement and the use of quick response codes?

It might sound complicated, but the hi-tech lingo is nothing new to practice founder Floyd Bradd and his partner Bernard Pegis. Bradd did his residency in family practice medicine, but after a few years practicing, he left to try out Emergency Room patient care.

"I didn't like it," Bradd said Wednesday afternoon as he sat in his office, which is decked out with computers, books and family pictures. "The patients came in, I helped them quickly, and then they were gone. I missed that continuum of care that you get in a family practice."

So in 1993, Bradd decided to start Skyline Family Practice. When it actually opened in 1994, he was using a "truly integrated" electronic health record system. He had 500 registered patients, he said, but the system didn't just hold billing information.

"That's why I say truly integrated, because this included their personal health history, medications, allergies ... all that," he said.

Now, 20 years later, the practice has gained national attention for embracing technology, yet still focusing on the patient.

In 2005, the practice began using screensaver patient information in each exam room. Ever room has a PC, which faces the patient at all times. While the patient waits for interaction with the doctor or nurse, images and facts pertaining to vaccines, common illnesses and local health stories pop up to keep the patient entertained, but more importantly, educated.

Bradd said he'll walk into an exam room to begin an appointment, but his patient will ask for him to wait until all the slides have gone across the screen.

"It's interesting stuff," he said. "They aren't just staring at a wall. They're seeing faces from around the community, which adds even more of an impact."

In 2008, the doctors jumped on board with electronic prescribing, something that makes a patient's life much easier. Through the use of a patient portal, which the patient can register for upon coming to the practice, a patient can message the doctor at any time with a prescription refill request.

Of course, the doctor has access to that patient's electronic health records.

"So, I go in and make sure that the patient actually needs the meds, and has been good with their previous prescriptions," Bradd said. "Then I can send a prescription right on over to the pharmacy. It's pretty simple, but effective."

The practice is virtually paperwork-free when it comes to registering a new patient, too. Just recently, the practice began using Kindles as a way to ask patients questions about their history or issue while they sit in the waiting room. The wireless device sets up a survey, and from there the patient's answers and information go to a front office worker, who then safely and securely imports the information onto the patient's electronic health record.

The process has increased efficiency, Bradd said, and his office staff has responded well to less paperwork.

Continuing to work with patient engagement, the practice allows patients to access their records, which betters their understanding of medication and family history information.

They can also see any information or instructions that were shared during an appointment, whether it be warnings about a medication, changes in their vitals, or suggestions for further research on a topic. Additionally, patients can check in to see when they should get lab work or a certain test done.

But it doesn't stop there.

The practice is a big user of Quick Response codes. The two dimensional barcodes hold information, and were originally used for businesses to scan and keep track of inventory.

However, according to Bradd and Pegis, Skyline's QR code-generation is the first that's specifically created for electronic medical record integration. FASText works as an add-on to the practice's electronic health record system, and once again "it's all about engaging patients."

During a time of increased smart phone use, it makes sense, Pegis said.

"How many patients really pay attention when the doctor gives them some instructions, or how many get the health hand outs and read them and store them in a safe place?" he asked. "What we can do now is put all that important information into a QR code, pull it up on the screen in an exam room, and the patient can take a picture of it and suddenly have all the details right there in their phone."

He said it's really stood out to younger patients, who enjoy having another reason to use their phone.

"We can even include links to websites, videos, suggested reading ... anything," he said.

Bradd added that adult children with elderly parents enjoy the added way of being on top of their parents' health and medications.

"They can scan the QR, share it with siblings, and we can give them access to the portal, so they can see if mom or dad is due for a test or prescription renewal," he said.

While a vast number of practices across the country have joined the electronic medical record revolution, Bradd recognizes that it will take time to get them to understand the value of QR codes and Kindles.

Tom Christoffel, a Front Royal resident and long-time patient of Bradd's, has embraced the technology.

During a Wednesday afternoon appointment, he jumped at the chance to download his updated health information to his phone. He insisted that use of technology in the practice does everything but get in the way.

"It will never replace the interaction between the patient and physician," he said. "If anything, this enhances that relationship, because I am getting all kinds of extra information, and I know [Bradd] is right there on the same page with me."

Bradd even did an EKG on Christoffel, simply by having the patient hold the doctor's smart phone while an app ran the test. The results were instantly available on the PC, and the two went over them together.

"The key is always the exchange of information," Bradd said. "But like I always say, it comes back to the patient. The patient is why I do what I do. The technology simply helps."

For more information on Skyline Family Practice's innovative use of technology, go to www.skylinefamilypractice.com.

Contact staff writer Kim Walter at 540-465-5137 ext. 191, or kwalter@nvdaily.com


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