It's almost mid 2011 and there are still some EMR detractors and doubters out there.
An article proclaiming "the jury is still out on electronic medical records" inspired me to
write this article. My "research" on this topic comes from several industry journals, the main
stream media, national physician blogs, my 34 years working with physicians and, most importantly,
from my best clients. While EMR critics make some valid points, the jury is "in" and the verdict is
that, all things considered, everyone is better off with EMR.
I'll start with the three biggest concerns about EMR. The first is information overload which
can confuse providers. EMR users agree that myriads of unwieldy information will work against
you, but suggest this phenomenon isn't unique to medicine as it is pervasive throughout our
high tech, gadget oriented society. Successful practices say they have avoided the overload by
prioritizing the data.
The second concern is that pay for performance might not work. While this may prove to be true,
successful users say they did not count on pay for performance incentives to justify getting
EMR in the first place. They see pay for performance as just another reimbursement scheme and
a totally separate issue. However, if pay for performance catches on, EMR users they are far
better armed to capture data than they were with paper. The third concern is EMR slows down
production, so it doesn't pay for itself. Again the successful users agree this can happen.
They avoided it when they designed the EMR template. EMR installation presented them with an
opportunity to redesign faulty information and patient flow processes. If they didn't take this
advantage, they would end up spending a lot of money "paving their old cow paths". Like anything
else, planning and more planning are crucial to success.
There are several reasons why electronic beats paper. Lost charges are virtually eliminated;
therefore cash receipts increase and arrive sooner. An organized, to the minute, legible
chart is available to you instantly. You don't have to search for the chart that is lingering
on someone's desk or in the back seat of a car. Documentation and the corresponding codes are
more consistent, accurate and timely. You are prompted to enter pertinent information which
results in a better record and less legal exposure. You can access a chart from anywhere: home,
car, golf course, emergency room, etc. via your notebook. Most of the critical information that
physicians used to "keep in their heads" is now available to those covering for them. The entire
patient visit, check in to check out, is timed.
This information helps identify where the delays in patient processing are. Reducing
unnecessary delays by just 2-3 minutes per patient can free up an hour of time per day
on your schedule. This means working smarter, not harder. The newly found time can be
turned into 2-3 more patients per day or going home at five instead of six o'clock.
Improving the process decreases staff frustration and improves patient satisfaction. EMR
gives you back all the space used to store paper records. Through attrition, you will
eventually eliminate transcription and medical record clerks. One of my larger clients with
15 providers, eventually reduced transcription from seven full time equivalents to one full
time and medical records from nine full time equivalents to one.
I have found that the successful implementation of EMR doesn't happen automatically.
It depends to a great degree attitude and your management team. The following axioms
usually apply to EMR:
1. Change is difficult and we are all wired to resist. Those who embrace or at least
accept change tend to be the ones who ultimately succeed, let alone survive.
2. If you don't lead, no one will follow. Change starts at the top of your practice.
3. Most of us tend to read what further entrenches our position or opinion. If you keep
listening for what you want to hear, you can't improve yourself or your business.
4. Misery loves company. Positive, energetic and creative people won't hang around very long.
5. If you're not invested in something, or someone hands you something, you quickly lose
interest. It helps to have some "skin" in the game.
My final thought is to be sure you are ready for EMR. You cannot force it onto a poorly
run practice and expect miracles. You might need an "outsider" to do a review and give you
their honest impressions and then recommendations to prepare for EMR.
