|
|
|
|
|
|
|
For the past several years, physicians and their staffs have been "going paperless" or implementing various forms of electronic medical records (EMR) in increasing numbers. We know, because we've been at the forefront, helping doctors deploy EMR software and hardware since the very beginning.
Misys Healthcare Systems is one of the leading healthcare IT companies with 2,400 employees. Every day, another group of physicians implements Misys EMR in their medical practice.
Changing the workflow in your office is not without risk. From the cost of an EMR system, to the time involved to get up to speed, adopting EMR is a big decision. And the old adage, "If it ain't broke, don't fix it" probably keeps many physicians from taking the plunge.
On the other hand, the promises of EMR are significant. Indeed, the stated goals of EMR are to reduce your overhead and cut costs while simultaneously increasing your revenues, and all while enhancing patient care.
So, what is the best way to analyze EMR? How do you weigh the risks of changing the way you do business against the possibility of a better bottom line and higher quality care from workflow improvements?
In the following sections, we'll examine the three major objectives of EMR and offer some experience-based analysis of the reasons behind the claims, real-life examples, and the factors affecting your likelihood of success. Objective #1: Reduce Overhead and Improve Efficiency
There are several ways EMR can reduce overhead. The most significant improvements are from savings in both physical and human resources.
Physical Resources
Chart materialsPhysical resources include the costs of buying chart materials, copying, and storing paper records. Within the medical records industry it is estimated that the cost associated with maintaining a paper record average $3 per medical chart, and that is the least of the physical factors. In addition to the file folders, there is the paper and printer toner, not to mention the cost per square foot to store filing cabinets.
EMR eliminates medical record storage costsThe physical space required for record storage is usually one of the more significant costs associated with keeping paper files. The cost of office space is always a significant part of overhead, and off-site storage costs must be counted as well. When a physician office does not have to store physical records, office space normally rented for record storage can be used for revenue-generating examination rooms and offices. Or the extra square footage doesn't have to be rented at all, thus allowing the same size office staff to fit into a less expensive office.
Human Resources
EMR saves time and increases efficiencyIn addition to the physical costs of materials and storage, EMR saves a a lot of of time. For example, the time wasted searching for charts is eliminated, and the increased efficiency can be significant. With EMR, the familiar scenario of staff members frantically searching the office for a particular chart is completely eliminated.
Time is also wasted by the singularity of paper records, because only one person at a time may physically handle a paper chart. For instance, if a pharmacy calls while the chart is being used, or waiting to be filed, the person taking the call cannot access the information in the timeliest, most efficient, manner. With EMR, all appropriate staff members can access the information whenever and wherever they need it—even from home.
Pulling charts, undoing them, copying them, and putting them back together requires both physical resources and time. Some offices also use outside copy services. In EMR-enabled offices, staff members just click and print whenever records are requested.
EMR allows fewer employees to do moreMany EMR offices are able to do more with fewer people. Human resource costs including staff salaries and outsourced transcription expenses are typically a large part of office overhead. Cost savings in this area are often a significant factor in achieving a positive return on investment (ROI) from implementing EMR.
In fact, some offices that rely on staff or outsourced transcriptionists devoted solely to medical records discover a 50% to 75% reduction of medical records expenses after adopting EMR. Where transcription costs typically range from $300 to $1000 per month per physician, savings from EMR can be significant.
Transcription costs can be lowered significantly or eliminated altogetherIndeed, some offices eliminate transcription costs altogether as the physicians enter all data directly into the EMR system. However, even if some or all of a practice's physicians continue to use transcription, these costs can still be lowered, because EMR makes in-house transcription much more efficient. For example, Misys EMR allows importing of any pre-existing or outside transcription prepared in Microsoft Word. Documents can even be imported in a fast batch mode. It's also simple to drop Word documents into a chart note or letter, or save a letter that was sent to a patient right in that patient's electronic chart.
Of course, the savings your office could expect depend on the amount you are currently spending on staff dealing with medical records, including outside transcriptions. Even if you do not downsize immediately, you may find as many offices have, that you can grow without increasing the number of staff members. Likewise, as employees leave by attrition they may not need to be replaced.
This increased efficiency, a result of generating the same revenue with fewer salaries and overhead, is a common result of implementing EMR – for both large and small offices. Although the smaller offices must have a minimum number of support staff, on average, EMR-equipped offices simply require fewer full-time employees to support the same number of physicians. Specifically, practices with an EMR system in place report two to 2.5 full-time employees per physician, compared with an industry average of four.
The need for 1.5 to 2 fewer full-time support salaries per doctor is a significant savings. Furthermore, the savings are not solely attributable to transcription-related costs. Rather, EMR contributes to an increased efficiency for the entire office. The reality of an EMR office is that there are far fewer chart pulls, significantly less filing, and far less time spent waiting for or searching for lost charts.
Enhanced communication increases office efficiencyIn terms of efficiency, better communications marks an entirely separate area of office improvement. Medical practices with EMR see a marked reduction in "phone tag" (leaving messages and waiting to hear back, or waiting to look-up the information and calling back) because the charts are always instantly available, and much of the critical messages are handled electronically, without a need to be on the phone at the same time. Additionally, EMR offices have fewer call-backs from pharmacies, significantly reducing staff time spent handling those calls.
The potential areas of cost savings from EMR are summarized below. For many physician practices, the improved efficiency and actual cost savings are more than enough to justify the investment in EMR. From an economic perspective, many doctors find that their bottom line is a net positive in the very first year following an EMR investment.
Physical resource costs
- Cost of materials to create and maintain paper charts
- Storage costs, including extra real estate and other costs eliminated without the need to store physical medical records
- Costs of copying requested medical records
Human Resource Costs
- Full-time employees devoted to medical records
- Pulling, disassembling, reassembling, filing charts
- Time spent looking for charts
- Transcription costs
- Communication inefficiencies, e.g., phone tag
Objective #2: Increased Revenue
Confidence in Coding—EMR decreases lost revenueEMR can improve the accuracy and documentation for coding. In order to avoid payment disputes due to documentation disputes, many providers and offices are conservative regarding coding. Industry research indicates that inaccurate coding often causes lost revenues ranging from 3% to 15% of a practice's annual revenue. On an annual basis, decreasing this lost revenue percentage can have an enormous impact on the bottom line of any practice.
EMR increases reimbursements because it facilitates complete documentation for every patient visit. With the use of templates and auto-text insertion, physicians can easily and fully document every note. EMR can help ensure that chart notes are compliant by mapping the templates to the appropriate coding rules.
Increase Services with Health Maintenance RemindersAdopting an EMR system also provides a powerful tool to help maximize the number of services offered for health maintenance. EMR systems often allow practices to search for all patients who are overdue for recommended services, or who are coming up on their annual check-ups. As a result, offices can send timely reminder letters to ensure better patient care while at the same time increasing service volume and revenue.
Increase Physician ProductivityWith EMR, many physicians are able to see more patients in a day. As a result, practices are able to generate more revenue with the same fixed costs in the same amount of time. Alternatively, many technology-enabled doctors use the additional free time to improve their lifestyle or work-life balance.
Other efficiency improvements improve the quality of life for the doctors using EMR as well. For example, in order to sign paper-based charts, each doctor must be physically present to sign the chart. With EMR, any component can be signed electronically from home or work, with no pulling or filing of charts.
Objective #3: Improve Patient Care
An EMR system can positively impact patient care in several ways. Some advantages involve increased efficiency and higher quality documentation while others involve automated checks and reminders to assist a physician in providing optimum care.
Improve Chart QualityEMR helps improve chart quality across an entire practice. All notes, documentation and prescriptions are perfectly legible in electronic form. Problems that result from poor handwriting or inconsistencies in documentation are virtually eliminated. And most EMR systems can automatically flag unsigned notes to make sure that all the charts are maintained across all providers in the practice.
Optimize Health MaintenanceComputerized checks and reminders serve to optimize health maintenance because relevant items can be either automatically flagged or even searched across the entire patient database.
In addition, EMR systems give physician offices important information at the time of documentation. For example, diagnosis-specific templates and checklists can guide and remind providers of relevant protocols and tests for certain conditions. Additionally, EMR includes age, sex, and disease-specific health maintenance reminders each time a chart is accessed.
Finally, physicians find it easier to engage patients more actively using EMR. Graphical representations can aid in-office education while patient handouts can be printed right at the point of care for less cost and delivered to the patient immediately.
Medication ManagementEMR ensures accuracy as you select medications from a drug database. Any prescriptions are automatically updated in the patient's chart note. Some EMR vendors use a drug utilization review feature to screen for potential drug therapy risks and print patient education information. Any potential drug-to-drug or allergic reactions are automatically flagged. In the case of a drug recall, the entire patient database can be searched for all affected patients in a few seconds.
Example: In the Event of a Drug Recall, it's easy to run a report showing all the effected patients
ConclusionThe advantages of EMR provide compelling reasons to consider the switch from paper charts. Decreasing practice expenses while simultaneously increasing revenues has been the real life experience of many physicians and practice groups. Likewise, it is possible to simultaneously improve quality of care for patients and quality of life for the physicians.
If you are considering EMR for your practice, you are not alone. If you have concerns about converting from paper to EMR, let the experts at Misys Healthcare help.
With 2,400 employees, Misys Healthcare is one of the largest healthcare IT companies in the world. From the largest hospitals to the smallest private practices Misys Healthcare has been helping physicians lower costs and improve efficiency since 1979. In fact, every single day another physician practice converts to Misys EMR.
Last year Misys Healthcare Systems led the medical IT industry in money spent on Research and Development. Still, it is our frontline experience with real EMR implementations in real offices that makes the difference. As we like to say, when it comes to changing the way your whole office works, experience matters.
|
|
