When the San Antonio Fire Department initiated a Well­ness Program in February 2011 for its 1,653 uniformed employees, no one could argue about the importance of offering employees a free annual physical. After all, what better way to ensure that firefighters are healthy enough to perform their job?

Peace of Mind

Maintaining the firefighters’ confidential health records was crucial. “We really wanted a place to keep and maintain paperless records. By not having any paper copies, no one could just pull a file and start flipping through it,” said Betsy Dose, Special Projects Manager, San Antonio Fire Department Office of Health and Well­ness. Waiting Room Solutions EMR provided a way for the department to add that additional layer of security.

SAFD Office of Health & Wellness Shops for an Urgent Care EMR

Dose recalled the extensive process she went through before choosing WRS Urgent Care EMR in her review. “This was all new to me. I started to look online to get information. It seemed like there was such a broad range of EMRs. We didn’t need this huge gigantic system. We just wanted something that would hold all of our information, that was easy to use and cost effective, because we didn’t have a lot of money to get this started. Affordability was definitely a big issue.”

Dose evaluated 30 EMRs and tested about half a dozen systems, including Alteer Office, Apri­ma, eClinicalWorks, and Ingenix Care Tracker. “Just having a monthly fee, without an initial large output, was really all we could afford. WRS was absolutely affordable. If a doctor created it, I knew that it would flow logically when he or she sees a patient and uses it,” said Dose.

Dose also visited a website which offers recommendations about various EMRs. “WRS was one of the EMRs that the site recommended, so that helped us narrow it down as well. Every testimo­nial I found on the website from other providers who were using its EMR was positive about its ease of use and capabilities.”

It’s So Easy

The San Antonio Fire Department implemented WRS just prior to the launch of the wellness pro­gram. Its small staff, which includes one physician and a medical technician, were not stymied. “It was simple enough with the instructions we were given. We did the online training. All of the different manuals that were available online have helped us out a lot. Dr. Miguel Vazquez is tech savvy. He has worked with EMRs before and he knows his way around computers. It didn’t take him very long to pick up on using WRS EMR,” stated Dose in her review.

Because of the extensive nature of the physicals, only eight patients are seen each day. “This was a challenge, especially at the beginning, so we asked them to go online and put in their medical history to save time once they hit the office. They are all coming in on duty and we want to keep them for as short a time as possible and still accomplish what we’re set up to accomplish in their physical,” said Dose.

The Convenience Factor

The physical is indeed comprehensive. It in­cludes vision, hearing, spirometry, vitals, a physical exam with the physician, a stress test and chest X-rays. “All of this information is recorded in the EMR. We put a computer in each exam room, so Dr. Vazquez could go in and pull up their labs and X-rays. Ini­tially, we do chest X-rays at the first physical and continue to do them every five years. The labs are done before they come in for their physical so the doctor will have those results to go over with them when they are here. Having everything handy is so convenient compared to digging through a bunch of papers. When the doctor wants to see a patient's labs from last year, he just clicks on the tab and he can compare the results. He can find out if the patient is better or if the patient's situation has become worse,” said Dose.

Dose has also found it easy to access WRS Urgent Care EMR from home or when on vacation. “A couple of times when I was on vacation and a question came up about scheduling, I logged into the system to find the answer,” stated Dose.

Information is Safe

No Worries Here

Dose said that while it is rare, there have been a few power outages in the city. She wasn’t the least bit worried about losing patient information. “We were scratching our heads, what are we go­ing to do now because we can’t get online? The city’s connections were down. We weren’t worried about losing information. We know it’s all stored on the WRS servers.”

Scheduling Perks

Because of the nature of their jobs, firefighters sometimes have to cancel their appointments. “We do all of our scheduling in WRS. It’s been great. It’s very easy to schedule and easy to cancel appointments. Since they are on duty when we see them, if they were scheduled but they can’t come in because they are too busy in the field, it’s easy to cancel the appointment or change the date. The system tracks when they were scheduled, even if you cancelled them, so you know they were cancelled and for whatever reason. We know they have to come back,” remarked Dose.

Pointing out in her review that Dr. Vazquez is the second physician on board since the program began, Dose said that he and the prior doctor customized the Urgent Care EMR to make it more convenient for the way they conduct their exam. “They’ve both gone in and customized the flow of WRS and put some standard comments that will automatically populate. Then they can go in and make changes if necessary. The physician who is here now doesn’t have any complaints. He took to it right away. He hasn’t had any problems and he is satisfied,” she said.

On the rare occasion that a problem arises, the WRS team has responded very well, according to Dose. “If we have any issues I know I can enter my concern online and you get a fast response. WRS has been there to help us.”

Finally, Dose said that while the department had to negotiate with its union to get the system, she added, “They totally understood that we are trying to keep up with the times. It’s really awesome that the employees can log in and see their medical file. That definitely is a neat aspect of the system.”

In explaining how the department’s wellness program came about, Dose stated the program is part of the International Association of Fire Fighters and Fire Chief’s wellness and fitness initiative. It is currently on its third edition that came out in 2003. “In the late 90s they started this program, which was modeled after NFPA (National Fire Protection Association) 1582. There was a nation­wide trend. People noticed that a lot of firefighters were dying on duty from heart attacks. They weren’t necessarily physically fit. They weren’t seeing their physicians regularly. As a city, that’s a huge liability to have someone die on the job. Of course, it’s terrible for them and their families.  It endangers the public and their fellow coworkers depending on the situation. If you have a fire­fighter in a burning building and he goes down, he’s a part of the problem, not the solution and that could put his fellow firefighters in that building at risk as well. We are divided into eight districts and we bring them in by district. We can see them anytime between six and 18 months,” said Dose.

Peering Ahead

An Optimistic Review

What does the future hold? San Antonio Fire Department’s future plans include expanding into in­fection control and when that occurs, having an Urgent Care EMR with unlimited accessibility will be a distinct advantage. “We are hoping to hire a nurse, who would be 24/7 accessible so I can see where that nurse might have to log on at home just to record patient’s exposure and what her direction was. Right now we have an infection control nurse on contract from the University of Texas Health Sci­ence Center. When this program became available and all of a sudden we had some medical staff actually on the city’s fire department payroll that seemed like a good opportunity. We can expand by hiring a nurse who can do infection control and it also can increase the capacity of what we are capable of here,” said Dose.

Finally, Dose concluded her review with this assessment of her EMR choice: “Waiting Room Solutions allows our medical staff to instantly access an employee’s medical information from any room or office; it is easy to navigate and provides for excellent documentation of the employees’ visit. It really helps provide good patient care. That’s what we want to do and Waiting Room Solutions is helping us do that.”

Urgent Care Testimonial