Two weeks ago, I described the hybrid EMR as a high-performance EMR, designed for and successful in high-performance practices. This has spurred conversations about the characteristics of high-performance practices, and why their needs for EMR technology differ so greatly from those of other practices.
There are two primary characteristics that differentiate physicians depending on their specialties—patient volume and total financial value of each office visit. Patient volume varies widely since the number of patients seen per day can vary from fewer than 15 for hospital-based, non-fee-for-service physicians to over 30 for pediatricians and dermatologists, and even far higher for many specialists such as orthopaedists and ophthalmologists. The total value of each office visit also varies widely, especially when adding in ancillary tests, procedures, and surgeries that may accompany office visits. Whereas the typical family practice physician generates less than $80 in total revenue per visit, ophthalmologists and orthopaedic surgeons can generate well over $200 per visit.
This chart compares patient volume and revenue characteristics among different types of physicians. High-performance physicians are those who see a high volume of patients and/or generate significant revenue per visit. The orange shaded area of the chart highlights the high-performance specialties: orthopaedics and ophthalmology are high on both scales; OB/GYN is moderate in volume, but high in revenue due to in-house ancillary tests and surgeries; and cardiology is lower in volume but generates high revenue due to the battery of diagnostic tests that stem from many exams. It is these high-performance physicians who, despite having the financial wherewithal to purchase a traditional EMR system, have the lowest adoption rates of those systems.
This chart is by no means an evaluation of the quality or importance of the care physicians provide; rather, it’s a measure of the intensity of their practices, which is why their needs for electronic medical records solutions differ greatly. Traditional (CCHIT) EMR products have not gained a foothold in the orange-shaded, high-performance area because even a small decrease in productivity for these highly productive specialists is too great. On the other hand, CCHIT EMRs have found some success among lower-volume, lower-revenue specialties, which fall in the unshaded area of the graph. A thorough reading of the CCHIT Certification Criteria reveals CCHIT’s primary-care focus.
Productivity-driven, high-performance practices demand EMR solutions that are productivity-focused. Hybrid EMRs are the only EMRs to enjoy a proven track record of success in this marketplace.