EMR Adoption: Why Are You Still on the Fence?

A growing number of physicians—particularly specialists—are no longer on the fence when it comes to the government’s EHR incentives. As evidenced by a recent spate of articles and blogs—one of the more compelling ones being “Is HITECH Working?: Key Physicians Will Sit on the Sidelines (At Least for Now)”—they realize that the costs outweigh the benefits. Physicians have decided that they:

  • Will not buy the type of EMR that is difficult to use and has not worked for other physicians in their specialty;
  • Will not risk the costs of a failed implementation;
  • Cannot tolerate the decrease in productivity—seeing fewer patients and generating less revenue;
  • Have established as a priority improving the quality of patient care they deliver, rather than collecting and reporting data that the government wants;
  • Cannot afford to take on unnecessary additional administrative burdens in the face of declining reimbursements;
  • Are not worried about potential penalties that will be relatively small, if they are even imposed at all; and
  • Are not interested in the government’s program, the benefits of which accrue primarily to other stakeholders, and not to their practice.
So why are these physicians, who have determined that government incentives are not relevant or achievable, still on the fence about adopting an EMR solution that will deliver measurable benefits? Staying with paper charts is not a good business strategy because there is nothing more inefficient!
  • The costs associated with the excess staff needed to manage these medical records are massive and wasteful—these positions can be eliminated or the employees can be more effectively used in revenue-generating or patient-care roles.
  • Paper charts hinder practice growth because adding physicians requires a proportional increase in support staff—medical records, billing, nurses, and medical assistants—and because physicians can’t see more patients without lengthening their work hours.
  • Slow responsiveness to primary care physicians limits referral volume.
  • Profitability is further affected by billing bottlenecks that delay revenue collection.
  • The chaos associated with trying to manage paper charts has a damaging effect on staff morale and creates rampant frustration among patients, physicians, and staff.
  • Paper charts are a malpractice nightmare—prescriptions are not consistently documented, orders are not easily tracked, and medical decisions are often made without complete clinical information.

You cannot afford to maintain the status quo.

Physicians can transform their practices without the government—there are excellent EMR solutions available, such as the hybrid EMR. It’s time to become digital. It’s time to get off the fence!

Here’s Proof: Your Time is Worth More Than You Think

When I speak with physicians and share with them this calculator, they are astonished to see the true value of their time.

Physician productivity is a major driver of practice revenue and profitability. Today’s rising practice costs, a more challenging reimbursement environment, the looming payment reform, a physician shortage, and the aging baby-boomer population make productivity increasingly critical. Whether you are comparing an EMR to paper charts, one traditional EMR to another, or a point-and-click EMR to a hybrid EMR, seconds count.

Last week, I suggested benchmarking to compare the relative effects on productivity of the different EMRs a practice might be considering. My EMR Reform plan includes “click” comparisons as a “report card” measure of efficiency. It may sound trivial—a few clicks more or less, or a few seconds here and there, couldn’t have much of an impact. But they do.

Consider this: approximately 80% of clinical workflow consists of the repetitive performance by physicians and medical assistants of 20% of their tasks. If generating a prescription requires 8 clicks in one EMR and 3 clicks in another, and each click takes just one second of a physician’s time, every prescription written has a potential impact—positive or negative—of 5 seconds on physician productivity. Add in the differential for other common workflows such as reviewing chart notes, sending a message, or reviewing and signing a test result (number of clicks, number of screens that must be navigated, etc.), and it is reasonable to assume that you can increase—or decrease—productivity by 30 seconds per exam, depending on the technology you choose.

For a typical orthopaedic surgeon who generates $1.1 million in revenue by seeing 125 patients per week, conducting office hours 20 hours per week, and taking 5 weeks of vacation, this 30-second-per-exam increase in productivity would enable this physician to generate an additional $57,000 per year (or $285,000 over 5 years). Conversely, an EMR that decreases productivity by 30 seconds per exam would cost this physician $285,000 over 5 years. Because this represents marginal revenue, it goes straight to the bottom line as almost entirely profit (or loss).