EMR implementation: Efficiency vs. incentives

By Paul Winandy
01:22 PM
Government incentives have made EMR implementation a hot topic for many medical practitioners. Everyone loves getting money back from the government, but don’t let the incentive money push you into a decision you will regret.
For any practice still using paper, the sales pitch is enticing. Integrate your operations! Go paperless! Improve profitability! Combine this with the government incentives, and the motivation to sign up is pretty compelling.
Unfortunately, the hype doesn’t match reality for many of these EMR implementations. For example:
  • EMR implementation and use can be so daunting that some have quit practicing medicine over it.
  • Only 11 percent of all customers for a leading EMR have achieved “meaningful use,” qualifying them for the federal incentives.
  • A recent study reported two disappointing statistics: (1) 31 percent of practitioners reported their productivity decreased after implementing an EMR and 43 percent reported no improvement in productivity; 38 percent reported that total practice costs increased after implementing an EMR and 36 percent reported costs stayed the same.
Nearly 75 percent of practices reported no tangible benefits from implementing an EMR. And about one-third of the practices had costs go up and productivity decrease for the most important people in the practice. No matter what kind of incentive you receive from the government, that math just doesn’t add up. Why would you buy software that may earn you a rebate in the short term, but actually causes you to see fewer patients and costs your practice money in the long term?
Part of the answer is that most EMR packages were originally designed to improve front-office efficiency by scheduling appointments faster, storing documents efficiently, and integrating with billing. A good EMR system will have any front-office staff grinning from ear to ear because of all the ways it makes their job easier. But frankly, who cares? It’s nice to make your front-office staff happy, but it doesn’t really save you money. You will likely keep the same number of staff working the same number of hours.
The truth is that the only determining business factor that should be considered in selecting an EMR system is whether or not it improves the practitioners’ productivity or tangibly reduces costs. Making the practitioners more efficient is what shows up on the bottom line, through increasing patient visits, improving patient care and/or providing more free time to grow the business.
Practitioners need to revamp their thinking when it comes to purchasing an EMR system. Here are some ideas to put into play:
Get involved. Don’t delegate the EMR assessment and decision-making to your office administrator. Demo packages firsthand and evaluate how each will impact your workflow, documentation time and day-to-day practices. This is a big decision that will impact your practice for a long time, so invest the time to make an informed decision.
Talk to your peers. Find out the good, the bad and the ugly on each of the systems you are evaluating. Get references from the EMR vendor, but find others through your peer network.
Focus on your efficiency, not your front office. Will you be able to complete your notes faster? Will you be able to see more patients? Will the EMR allow you to have more face-time with your patients? Will it help you improve patient care?
Ask about training time. If the system takes two weeks of training time to learn and months more to master, then it is way too complex. Are you really going to be able to invest that time to become proficient? An intuitive software system allows you to learn it fast, with little instruction, and be productive in short order. 
Do your homework. Ask all the right questions before you buy. Keep in mind that the costs to switch to a different system are very high. There are some nice buying guides available for free to help guide your questions to the vendor.
A great example comes out of the therapy industry. Therapy clinics do not qualify to receive government incentives for EMR adoption, yet they are signing up for EMR systems in droves. Why go through the pain and cost of implementation if you don’t have an incentive driving the decision? Simple, the EMR solutions available to therapists deliver economic benefits. These solutions match their workflow and are tailored to their specialty, saving dozens of hours a month that used to be spent on documentation and other practice management activities. Those hours are going right back into the practice, allowing for additional patient visits, more marketing time and improved patient care. 
The bottom line is that an EMR system should make you efficient, improve patient care and save you money. If it doesn’t you should part ways with your vendor and try again.
Paul Winandy is CEO of WebPT. He can be reached at paulw@webpt.com. This post appeared at EHRWatch.com.