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June 21, 2011 News 1 Comment

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The EMR Debate Goes On: To Implement or Not to Implement? That is the Question for Today’s Physicians
By Keith Slater

6-21-2011 8-14-03 PM

There has been a great deal of debate among physicians about the true value of electronic records. A survey conducted by MGMA earlier this year found that 78% of medical practices that are still using paper-based records thought they would face a “significant” or “very significant” loss of productivity during EHR implementation, while 56.9% said “insufficient expected return on investment" was a barrier to investing in EHR systems.

In that same survey, however, 72% of physician practices who had completed EHR implementation were “satisfied” or “very satisfied” with their systems. In addition, the survey reported that fully optimized EHR systems led to greater financial benefit.

Despite the results of the MGMA survey — as well as other surveys exploring EHR adoption — the hesitation and concern some healthcare providers still have is understandable. However, as the healthcare industry moves towards becoming fully electronic, deadlines related to new CMS Meaningful Use regulations loom. There is a great threat to further reduced payments to providers who lag behind in technology, which must be quickly realized and dealt with by all physicians.

Paper records do not, by definition, demonstrate compliance with Meaningful Use regulations. With Stage 1 deadlines on the horizon, practices will face lower payments from CMS as a penalty for staying with their legacy paper systems.

However, when you look at real-world data of the costs to create a single new patient chart, the dollar figures provide the evidence and support for EMR implementation. According to data based on a six-doctor practice, the elimination of paper charts in favor of implementing an EMR can reduce the cost of maintaining records by as much as 87% while increasing billings by more than $145,000.

The figures just don’t lie.

A clinic and surgery center that has 14 providers seeing an average of 1,800 patients and conducting 240 procedures per month averages the cost to create a new clinic patient paper chart, factoring in printing, stick-on tabs, copying, and labor, at $5.35. Seeing roughly 75 new patients each day, the organization spends a total of $104,325 annually in materials and labor. Creating a new surgery patient chart costs the organization $16,134 annually, for a grand total of $120,500 between the two.

It is also worth noting that some medium-size practices spend $200,000 per year on labor associated with managing and trafficking paper charts.

Overall, when it comes to EMR implementation, physicians must carefully and accurately weigh the long-term benefits with the short-term hassles. Yes, there is an upfront cost to EMR implementation. Yes, there may be a slow-down in productivity at the beginning while staff members are learning the new system. But if the practice takes its time in knowing what its needs are, the goals it wishes to reach and approaches EMR adoption with an open mind, the sooner it, too can start reaping the benefits.

Keith Slater is vice president and general manager at Henry Schein MicroMD of Boardman, OH.

Comments 1
  • This article by Mr. Slater was written 15 years ago. And ten years ago. And many times since, up until his latest trotting out of it today. Its the old school argument that the cost of purchasing, creating, maintaining and keeping track of paper records is worth the investment in EMR alone. If that argument hasn’t worked for the past 15 years to get better adoption rate of EMR going…THE PROBLEM MUST BE SOMETHING ELSE. And it is. I’m surprised he didn’t add the other pieces of the “old school” EMR justification case: “You’ll eliminate all that dictation costs!” That hasn’t revolutionized the market with any better adoption of EMR either. Lost records and charts, plus reduced medical errors are the other two pieces of the old justification pitch. Yada Yada.

    When will vendors, like Mr. Slater represents, stop with the “old school” arguments that never seem to get much traction with providers and practices? While the arguments still do hold water, they are clearly NOT the critical path…without what Paul Harvey would call “..the rest of the story”. And that’s the productivity issues providers really are concerned with. What are the “productivity issues”?….fear of not being able to see as many patients because of the TIME entering data in an EMR takes; fear of not being able to find what is needed in the electronic system; concerns over lost revenues from having to see fewer patients; concern that NOT filling out something correctly in the EMR could lead to adverse consequence; lacking the conviction that changing to electronic from paper REALLY has much benefit at all, given the cost and “change” factors. Plus the concern that providers really don’t know “computers” well enough to abandon a very familiar, if tedious, paper system. Those are the issues I see every day.

    So, Mr. Slater goes back to dealing with only the “vendor half” of the equation. Until practices are assured that the “practice” issues—the many-headed productivity concern—will not be headaches…the EMR conundrum will continue, ARRA incentives or not.

    So lets raise the dialogue level…leave the paper-saving talk behind. EVERY provider already sees that, for goodness sake. Vendors have been pounding on it for 15 years. Lets deal with the issues that really bother them and the adoption rate will improve dramatically.

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