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Has EMR Adoption Time Arrived?

October 16, 2007
by John Thomas
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Despite sound reasons to implement, many practices have not embraced the electronic medical record.

There has never been more emphasis on electronic medical records (EMRs) and electronic health records (EHRs) than now for group practices and healthcare organizations of all sizes.

While most agree the introduction of technology in the clinical setting enables numerous possibilities for driving the use of data and improving efficiency, the majority of group practices today do not utilize EMRs or EHRs. Regardless, the message is clear — technology will play an increasing role in the daily expectations surrounding the patient encounter at all levels.

In general, common EMR/EHR benefits can be categorized into cost savings/control and revenue-enhancement opportunities. The cost savings and control benefits are increased staff and provider productivity and decreased practice overhead.

Specifically, staff productivity increases as charts become available and accessible, and paperwork for patients is reduced. Additionally, the electronic tools implemented, such as document management and referrals management optimize workflow, increasing productivity and reducing costs.

Provider productivity is also boosted by the chart access and availability. Other factors contributing to the surge include prescription management, automated review and electronic signature of clinical data.

In addition, practice overhead decreases overall, due to the reduction in overtime, clerical-support needs and transcription costs. Paper supplies and paper-based services are also eliminated, and needed storage space is reduced.

In addition to these benefits, there are a number of common revenue-growth opportunities. EMR/EHR improves documentation supporting revenue cycle management activities and increases contract-negotiation power. It also enables participation in clinical trials, as well as the analysis of discrete data to empower delivery of new or more profitable services.

So why not?

Despite the potential benefits, barriers to implementation remain. HIPAA, interfacing capabilities, legal issues and competition continue to impact the necessary agreements required to enter into the EMR/EHR world. These four overriding challenges, in addition to the expected high cost and fragmentation of the marketplace, will continue to slow EMR/EHR adoption in private-practice settings.

According to "Health Information Technology in the United States: The Information Base for Progress," a report by the Robert Wood Johnson Foundation and the federal government's National Coordinator for Health Information Technology, less than 10 percent of physicians fully utilize information technology and only 25 percent use some form of EHR today, which is unchanged from years prior.

With that, here are some recommendations for practices navigating the EMR/EHR adoption process. First, it is critical when considering EMR implementation to focus attention on strategic planning for the organization prior to engaging product-specific solutions.

One should clearly define what the future state of clinical automation will look like for its practice in terms that everyone within the practice can envision. This will help center decision-making on key execution steps and risk analysis/mitigation planning necessary to ensure successful implementation.

The key to introducing technology into the practice is to understand that technology is not a magic answer in and of itself. Additional value is driven by understanding current needs as they relate to the introduction of EMR/EHR and using the technology to support a well-thought process.

While EMR will continue to play a role in the revenue cycle, by itself it is not a technology today that will guarantee revenue cycle excellence. In fact, the overall implementation of EMR should maintain and enhance revenue cycle performance.

Based on practice need and resources, a phased approach to EMR/EHR implementation will net the greatest buy-in and the best chances at garnering a quantifiable return on investment.

Looking forward

There is no doubt the U.S. healthcare system will evolve toward interoperable EHR/EMRs to improve patient care. Funding, HIPAA, Stark, cost burden, marketplace fragmentation, technology interfaces and pricing pressures will hinder its rapid adoption; however, all parties agree that the status quo must change.

Because of this potential for complexity, it may be difficult for even a technology-savvy organization to clearly distill a vision for its future. If an organization is experiencing this difficulty, a key first step is to align with a recognized, trusted business partner. An organization rich in vision and process planning capable of providing detailed analysis encompassing the clinical and financial needs is integral for success.

John Thomas, president and CEO of MedSynergies Inc.