MGMA Confirms Productivity Loss with Government’s EMR Program

What struck me at last week’s annual meeting of HIMSS (Health Information and Management Systems Society) was the conspicuous absence of conversation about the effect of the ARRA legislation on physician productivity—there was hardly a mention of the subject throughout the conference. Jeffrey Belden, M.D., of the HIMSS Usability Taskforce, did point out that documenting patient exams in an EMR takes 10 times as long as documenting by dictation, but offered no solution to that problem. Admittedly, the audience contained few, if any, physicians. However, once again, it struck me that physician productivity was the elephant in the room—the topic that no one was discussing, even though physicians are the very people upon whom the success of the program is so dependent.

I arrived home to the release of the results of a new MGMA study (conducted last month), which concluded that practices expect that the operational changes required to meet the proposed meaningful use criteria will cause a significant decrease in productivity. Nearly 68% of the respondents anticipate such a decrease, with 31% projecting that the decrease would exceed 10%—and this was likely based on only the impact of Stage 1 meaningful use criteria.

This productivity loss is what I described in last week’s EMR Straight Talk post, where ARRA meaningful use requirements compound the reduction in productivity that is already associated with the “point-and-click” EMRs themselves. Before ARRA, physicians estimated that traditional EMRs reduced their productivity by between 20% and 40%, as documented in testimonials posted on the Government’s FACA blog and included in the Voice of the Physician Petition. Others are speaking out about this issue as well; Paul Roemer reported that his cardiologist puts the productivity loss at 30%, due to the amount of time that he “wastes” performing clerical—i.e., data entry—tasks. (Read his comments in “Healthcare IT, How Good is Your Strategy: A Scathing Rebuke of EHR.”) Added together, this means that physicians face a 40% reduction in productivity at the outset. Imagine what will happen to productivity when the more stringent Stage 2 and 3 meaningful use criteria are implemented!

The conclusion is clear. Physicians should not be considering EHR adoption for the incentive money; they should be looking at what will help them address their business and patient-care needs. The HIMSS keynote address by chairman Barry Chaiken, M.D., charged the EMR industry with “creating healthcare IT solutions that are so compelling, so irresistible, that people just want to use them.” Systems like that already exist—they just don’t interest the government, which appears to be more interested in data collection than EHR adoption.

3 Responses to “MGMA Confirms Productivity Loss with Government’s EMR Program”

  1. In all this, no mention of the lack of quality of the note. We are a specialty practice, and EMR notes for referrals tend to be many multiple pages of nothing relevant. When you send a referral it helps for the doctor to know why you are referring a patient. These EMR notes tend to forget the reason for a note, it’s a statement of the problem and what’s being done, not an entire recent history of health status and temperature readings. These notes in themselves are a waste of a specialists’ time.

    jeff

  2. I don’t know much about the HIMSS, but I do know that most higher ups who are making decisions that affect the medical world are hardly ever doctors. Which would explain the backwards world we live in.

  3. Thomas Henderson, MD May 21, 2011

    I went through EMR startup in December 2010. The result was a 50% decrease in collections for 1 month and slower patient progress through our practice still at 6 months. I have always used a scribe to enable me to focus directly on the patient, and the EMR has shifted more work onto them from other clerical workers in the office. We remain about 5% less efficient now 6 months later. For new offices adopting EHR, I would recommend, based upon my experience that full loads be maintained, but that EHR be introduced on NEW PTS ONLY for 1 or 2 months until all kinks are worked out and apopropriate adjustments are made, before expanding to a larger percentage of patients. At this time I am not sure that we will ever exceed our previous productivity; however, I still believe that in the long term there will be non governmental pay-offs that exceed our 100K$ investment and similar short term loss of productivity.

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