Khoury Surgical Group, OH USA



Among busy career people perhaps no group today finds itself busier than medical professionals. With a large and aging population of Baby Boomers needing increasing amounts of health care, medical personnel are busier than ever – particularly those who specialize in areas with large numbers of older patients. That is certainly the case for the Khoury Surgical Group whose focus is cardiac, thoracic and vascular surgery.  Dr. Rajai Khoury started the Khoury Surgical Group about nine years ago, and it has since grown to three sites and three partnering physicians in rural West Virginia and the Ohio Valley. With a growing practice comes the challenge of maintaining excellent patient care while staying abreast of new innovations in technology, including Electronic Medical Records (EMR). In 2010 the Department of Health and Human Services (HHS) mandated all medical practices receiving Medicare or Medicaid reimbursements to demonstrate “meaningful use” of EMR by 2015 or face penalties in the form of automatic reductions in payments. For the Khoury Surgical Group this has special significance because over 80% of their patients are on Medicare. Long before HHS established the EMR deadline, Dr. Khoury had already begun planning to transition to EMR, but like many busy physicians he set aside this costly and time consuming project to focus upon growing his practice and caring for his patients.


The Khoury Surgical Group is a model of teamwork that transcends cultures. Their three primary physicians hail from around the world (Gaza, New Jersey and China) and meet together each night to go over their patients’ cases and collaborate on their care. This collaboration is paying off – the Khoury Surgical Group is widely known throughout the area for the skill of their surgeons and providing excellent patient care. For example, in their community Dr. Carl Barosso is the only board certified vascular surgeon and for the last two years Dr. Xingyi Que has performed the largest number of cardiac surgeries with the fewest complications. Their founder Dr. Khoury is a highly respected pillar of the medical community, having been in practice there for over 30 years. He also donates his time and expertise for medical missions trips abroad. Unlike many physicians who have practiced medicine that long, Dr. Khoury was not afraid of adopting a new technology to switch from the old manilla file folder system to EMR. He was also well aware of the HHS incentive program to reimburse doctors for the costs of adopting EMR (up to $44,000 for Medicare and $63,750 for Medicaid.) Though armed with the best of intentions he still had to manage a growing practice and increasing caseload, and the Khoury Surgical Group found themselves in September 2012 with no system in place and less than a month to make the transition to EMR to receive the maximum incentive money.


Gail Que’s neighbor is a primary care physician. Knowing that Gail was a registered nurse he asked her to assist his practice in their transition to EMR, using her nursing expertise to help them best understand how to fully integrate the ZH Healthcare EMR software they purchased into their practice.  Gail says they chose ZH OpenEMR after extensive research by a computer engineer who serves as head of computer security for a bank. As Gail and the staff began to implement the system they were immediately impressed with how easy it was to learn. Gail said she was most impressed with its flexibility, which can be customized to meet the unique needs of a particular physician’s practice. Gail’s work with ZH OpenEMR gave her a thorough understanding of the system and invaluable experience in helping a medical practice transition to EMR. And fortunately for the Khoury Group she is also the wife of Dr. Xingyi Que. “They were very happy with the results” she reports, “so when Khoury Surgical Group wanted to use EMR I recommended this the ZH OpenEMR solution.”


By the time the Khoury Surgical Group had all the pieces in place to implement EMR, the HHS deadline was only two weeks away. “We needed something quick and easy to learn” said Gail. Fortunately for them ZH OpenEMR proved to be both. Within two weeks all of the staff – including the doctors, nurses and front office support personnel were able to learn the system and get it operational. “The software capability and flexibility was very impressive,” she says.  Aside from Gail’s help, another big reason they were able to so rapidly implement the system was the ZH Healthcare customer support team. “They were easy to get in touch with and very helpful…very friendly and effective. Those guys work really hard”, says Gail. Her husband Dr. Que “loves this program” she says, because of its time savings, quality control features, and ease of use; for example, the ability to access and print a patient’s records from virtually anywhere. ZH OpenEMR is cloud-based, and if a patient has to be rushed into surgery their records can be accessed and printed right on site at the hospital, eliminating delays and dictation mistakes. Asked if she had security concerns about a cloud-based system, Gail reflected upon the research done by the computer engineer and head of electronic security for a bank that originally chose ZH OpenEMR for her neighbor’s practice. “I have no concerns. He was very confident in their level of security” she said.

The Khoury Surgical Group began with ZH OpenEMR in the first year to satisfy Medicare Stage 1 requirements. Having successfully accomplished Stage 1 and received the incentive monies, this year they are moving on to Stage Two. In addition they are also creating more custom templates for their practice, which will increase the system’s effectiveness. While not every medical practice will be fortunate enough to have a nurse available with previous EMR exposure, the Khoury Surgical Group’s experience demonstrates that its short learning curve, ease of use and reliability make ZH Healthcare’s OpenEMR solution a great choice for any busy medical practice wanting to make the transition to EMR.