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The Blues and the Office EMR

March 28, 2008
by James Feldbaum
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The American Medical News recently reported: “Insurer finds EMRs won't pay off for its doctors”. According to the article, the Massachusetts Blues have come to the conclusion that the financial benefits of office-based electronic medical records do not seem worth the cost for its physicians. Because they have concluded that only $.11 of every dollar saved by the use of information technology benefits the physician, they have decided not to require physicians to install an EMR in order to participate in their bonus program.
They did, however, stick by their conclusion that CPOE makes financial sense in the hospital setting and will continue to require health systems to install CPOE by 2012 to participate in the bonus program. For many of us, even as strong supporters of the office EMR, these findings are not surprising. In a previous blog entry I discussed some of the hurdles faced by practitioners seeking to implement an office EMR. Although the Blues did not do a formal study of physician practices, they estimated that it would take five to six years for an EMR to recoup its costs in an office-based practice. Increasingly, practitioners recognize the EMR as a value to the quality of care that they deliver to their patients, yet they remain disheartened by the high cost in time and effort that it takes to implement one. However, one must take into account the change in practitioner demographics as we baby boomers retire and a new generation of tech-savvy practitioners takes our place. There are a number of good reasons to be optimistic for a wide-spread acceptance of the office EMR in the years to come. First, the new generation of practitioners will universally expect the benefits of a practice EMR. Second, a start-up practice will require less time and effort to initiate an EMR compared to an existing practice’s effort to convert to one. Third, the functionality of the office EMR is constantly improving and soon the cost/benefit ratio will swing in favor of implementation. Last, with the relaxing of statutory inhibitions practices can look forward to subsidies from their healthcare systems.

All human situations have their inconveniences. We feel those of the present but neither see nor feel those of the future; and hence we often make troublesome changes without amendment, and frequently for the worse.
Benjamin Franklin (1706 - 1790)
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James Feldbaum

Jim Feldbaum is a physician consultant specializing in clinical transformation, CPOE, and...