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.

An Open Letter to HHS Secretary Sebelius

We are very encouraged that the Voice of the Physician Petition has been acknowledged at the highest levels of government. After HHS (Department of Health and Human Services) Secretary Kathleen Sebelius received the petition that SRS sent to her—and simultaneously hand delivered to the HIT Policy Committee—Secretary Sebelius asked Dr. Blumenthal to respond to me. As head of the Office of the National Coordinator for Health Information Technology, Dr. Blumenthal chairs the HIT Policy Committee and, together with Secretary Sebelius, will accept or modify the recommendations on “meaningful use” and EHR certification that come from that committee and from CMS (Centers for Medicare & Medicaid Services). In the interest of continuing this conversation, I am extending the following invitation to Secretary Sebelius, as I already have to Dr. Blumenthal:

Dear Secretary Sebelius:

I received Dr. Blumenthal’s letter and was glad to hear that you appreciate the input provided in the Voice of the Physician Petition. The ability of the EHR incentives to successfully encourage widespread adoption of EHRs is inextricably linked to the belief by physicians that EHR technology is of benefit to them, as well as to all the other stakeholders in the healthcare delivery system.

I would like to arrange a brief meeting with you to discuss these very important issues in person. As the CEO of SRS, with 12 years of experience listening to and working with front-line physicians, I can offer you some valuable insights into what community-based physicians are looking for and how they perceive the legislation—likely a different perspective than that being presented by committee members.

SRSsoft was recently named to the Inc. 5000 list of most rapidly growing companies, and was identified as one of the top 100 healthcare companies. Our success and growth is directly attributable to the fact that our EMR development is driven entirely by the needs of private-practice physicians.

As the representative of thousands of physicians who want their voices heard—SRS clients and non-clients alike—I would be happy to come to Washington to talk with you. I am confident that you would find the conversation valuable.