By Shilpa Amin, MD, FACEP 
When Emergency Medical Associates (EMA) is integrated into a hospital system, we ensure the highest standards of service on many different levels. EMA was founded in 1977 and has grown into a practice that’s taking the lead in various areas, including practice models, patient satisfaction, EMRs and using medical scribes. As a partner of the company, I’m proud that we’ve been named to Modern Healthcare’s Best Places to Work in Healthcare list for three years. In fact, EMA is the highest-ranking medical management company on the current list.
So how did we come so far? Below are my thoughts on how we accomplish the high goals set by the partnership.
Democratic Partnership: EMA is a rare practice in that it’s truly a physician-led and owned practice. Our physicians govern the company and set the goals yearly for the practice. All our partners have a voice and vote in the company. Our 97 percent retention rate speaks to how we create a culture where physicians can grow and find satisfaction throughout their EM careers. We have initiatives in place to help develop young leaders. We provide many opportunities for our partners to contribute to the company, whether it is a director of an ED, by joining a committee or even becoming a board member and helping run the business side of company. We are closely linked with the New Jersey chapter of the American College of Healthcare Executives (ACHENJ) and one of our corporate directors will assume the role of president of the chapter this spring.
Pioneering EMR and Scribes: EMA created a boutique electronic medical record, EDIMS, which stands for Emergency Department Information Management System. This program was created for and by practicing emergency medicine physicians, who worked along with a team of both IT and risk management contributors. This technology has allowed us to track and trend the patient data that we have collected over the years to develop research projects. Our practice also was among the first to use scribes in the ED. Our comprehensive scribe training program enables scribes to work closely with providers to ensure timely reporting of labs and radiology reports and ensure efficient chart completion. Our scribes are an integral part of our team and help decrease length of stay in the emergency department.
Client Account Managers (CAMs): Each EMA site is assigned a client account manager to help with day-to-day operations in the ED. Our CAMs are former nursing or ED administrators who have a wealth of knowledge about increasing productivity and efficiency in the ED. They serve as key liaisons between our practice and the hospital.
Operational Metrics: At times it seems like we analyze everything! We have an amazing practice management team at our corporate headquarters that evaluates data and practices to find new ways to improve ED operations. We measure a variety of outcomes; including door-to-provider time, door-to-discharge time, and admission-order–to-floor time, just to name a few. We consistently review these metrics during our monthly business meetings to discuss ways to improve these times.
Observation Units: EMA works closely with hospital administration to improve patient throughput and patient satisfaction. At one site, the team noticed that patients were waiting in the ED for chest pain observation, abdominal pain radiologic and consultant evaluations and TIA neurological testing. Often, these patients occupied beds that could’ve been used for patients waiting to be seen in the ED waiting room. The medical director approached the hospital’s administration about creating an observation unit that would function as an extension of the ED. Our physicians would continue to care for these patients and would work closely with the medical staff to ensure proper testing and evaluation was conducted for the patients. Once evaluated, patients would be discharged or admitted from the observation unit. The hospital’s administration consented, and this observation unit continues to be one that other EDs use as a model.
Community Outreach: Our physicians consider themselves a part of the hospital, and by extension, a part of the community that the hospital serves. Our clinicians contribute to hospital boards, committees and lectures. They participate in various hospital functions, such as fundraising events, galas and golf outings. Our physicians often speak to local and national news media. Many of our physicians take part in medical missions, most recently traveling to Haiti and Mexico. And, our partners participate in educational forums with local EMS, teaching EMTs about various disease processes and how to improve pre-hospital care.
Regional and National Chapter Involvement: All EMA physicians belong to ACEP, SAEM, AAEM or ACOEP . One of our partners, Michael Gerardi, MD, is the president-elect of ACEP. Our President and CEO, Ray Iannaccone, MD, was the Chairman of Democratic Group of ACEP. We truly understand the importance of these chapters and associations and their efforts to improve emergency medicine as a specialty. Our partners are involved in many committees and sit on various boards of these national groups.
Hospitalist Programs: Often times when the hospital administrators approach EMA to run the ED, we are tapped to provide additional services. Such was the development of our hospitalist and house physician program. EMA provides hospitalist services at six hospitals. The team approach of having the same company run the ED and hospitalist program has allowed for smoother transitions during admission and decreased length of stay in the ED.
After nearly 40 years in emergency medicine, our practice fully understands how an ED functions in relation to the rest of the hospital and the department’s importance within the community. Our physicians are committed to building long-standing relationships with each hospital and the communities that they serve. We have set the bar very high and expect only the best medical care from our team.
Shilpa Amin-Shah, MD, FACEP, is a full-time attending emergency physician at Saint Barnabas Medical Center in Livingston, N.J. Dr. Amin is also the Director of the Physician Recruiting Team with Emergency Medical Associates, Parsippany, N.J. She received a bachelor’s degree from Rosemont College in Rosemont, Pa., and her medical degree from SUNY Downstate, Brooklyn, N.Y. She completed the Jacobi/Montefiore Emergency Medicine Residency Program at Albert Einstein College of Medicine and served as chief resident. She enjoys spending her free time cooking, traveling and trying new cuisines with her husband and two young children.
