Stimulus Package EMR Programs Encounter Execution Issues

If you want to read thought provoking articles on EMRs and the Stimulus Package, the below links offer interesting perspectives and relevant facts, providing readers with the knowledge needed to make informed decisions regarding EMRs usage in their practice.
EMR and HIPAA: Allscripts CEOs stunning take on Obama’s EMR Plans

Healthcare Informatics Blog: Ephraim Schwartz: Financial and Technology Issues make Obama’s EHR push not so Easy to Execute

Healthcare Reform

The AMA has created a series of white papers addressing Healthcare System reform. The Obama Administration as stated that Health System Reform is a top priority, and the AMA encourages doctors to use this as an opportunity to resolve current issues to enhance patient care. With a standardized health system, increased quality of patient care will inevitably occur as systems work among various medical institutions to deliver more efficient and effective treatment options. Visit the AMA website for more information.

Change Management Reported to be the Cause of Majority of EMR Issues

Do doctors have a reason to worry about transitioning to an EMR? Once you start talking about technology, software vendors, and EMRs, doctors who haven’t transitioned to an EMR can get nervous about how this would work in their practice. However, that’s not what they should be worried about.
According to Wikipedia, the Agency for Healthcare Research and Quality's National Resource Center for Health Information Technology report that EMR implementations follow the 80/20 rule; where 80% of the work of implementation is spent on issues of change management, and only 20% is spent on technical issues related to the technology itself.

Since much of my professional career has involved EMR implementations, I agree with this statement. Time and time again I have seen offices fear the software and struggle with fitting their current business processes in with how the software functions, and this can lead to frustration and failure. Almost anything can be carried out more efficiently when proper planning has been done, and implementing an EMR is no exception.

Long before the software is installed on the computers in the office, doctors should be analyzing their current business processes to identify bottlenecks and areas of improvement. This can serve as two purposes. You can identify the areas that will affect the EMR implementation (staff's level of technology expertise) and have an action plan on how to resolve it prior to the EMR implementation, and you can also identify areas that you want the EMR to resolve. Finally, you can address the issue with staff spending countless hours searching for paper medical records!

Physician Frustration Grows with EMR Vendors

“It’s difficult to keep IT interested in the discussion. They don’t take the time to really understand the problem and want us to adapt to whatever software they come up with.”
This was one of comments made about EMR vendors in the 2009 ACPE Health Care Technology Survey. I find this so unfortunate, that physicians feel that IT vendors do not want to improve and enhance doctor performance. There is truth, though, with saying that IT wants physicians to adapt to the software they create. Unless the software company builds custom software applications, there is no way that a vendor can create software that will work for every single physician practice. There are too many variations to how offices perform daily tasks. So, there really isn’t any getting around this, there will be some modifications needed to the practices daily business processes. However, this shouldn’t be misconstrued that IT doesn’t take the time to understand the issues.
What doctors may not realize is that many EMR vendors employ business analysts who are experts in their industry and are trained to analyze business processes, then convert them into a software program for a programmer to code. Once the core product is ready, vendors will typically release updates to the software, which are additions to the core product to handle the many variations, thus accommodating more practices and how they currently run their business, with minimal changes needed in their current business processes.
Ultimately, doctors need to realize that EMR vendors do want to solve problems. While there are always exceptions to the rule, physician practices need to be open and accept the changes outside of the technology that will occur with the use of an EMR. We can all agree that email is much faster, reliable and preferred to regular mail. However, we all had to change how we communicated in writing to people through shorter, more frequent messages versus less frequent long letters. We also had to adapt to the changes in time management this caused since messages could be delivered instantly versus 1-7 days by regular mail, depending on where the recipient lived and what mail method was used to send the letter. This is a very simple and basic example, but you get my point. Sometimes, changing business processes is a good thing.
Read the full survey at http://net.acpe.org/MembersOnly/pejournal/2009/MarchApril/Weimar1.pdf

Business Justification to Implement an EMR

A study from the New England Journal of Medicine shows that 66% of physicians surveyed are not using an EMR due to cost. This is an overwhelming sign that physicians cannot make a business justification to implement an EMR in their practice. This article talks about that study in more detail http://localtechwire.com/business/local_tech_wire/biotech/story/3114344/.

However, a significant business justification can be made for most practices and it’s important not to cut corners with cost because you could end up trading quality for a cheaper price. Yes, the upfront costs can be hefty, but a cost analysis projecting 3, 4, 5 years ahead will show how technology lowers costs. Consider this:

Financial
An EMR will replace your current documentation system (dictation, voice recognition, etc.). Therefore, you will immediately save money by eliminating your current documentation process.
By using technology, you will decrease your use of paper, postage, & printer ink, an additional cost savings.
With a quality PM & EMR system and effective implementation with doctors entering information real-time, billing is a more efficient process, often with a decrease in billing errors. This often results in a reduction in billing staff, an additional cost saving.
Many EMRS & PM systems provide high quality error checking capabilities, reducing medical errors, and increasing reimbursement.

Productivity
By utilizing electronic billing, payments are received in half the time of paper claims, creating a more efficient billing and accounts receivable process.
Office workflow can be altered to implement more efficient procedures & eliminate duplicate work and redundant processes, thus increasing office staff productivity.
The reliability and ease of use of EMRs & PM systems will also increase staff productivity. When information in a chart is needed, staff members can search for that information at their desk on their computer, while still being available to answer phones and interact with patients. This is a much better scenario than having to send a staff member away from their desk & other job responsibilities to search for the information in a file cabinet.

Patient Care
Many EMRs will help guide the physician based on the symptoms of possible diagnoses & treatment methods, increasing the quality of patient care.
With a more efficient office, the average patient wait time can decrease significantly, increasing overall patient satisfaction.
While the business justification to implement an EMR will vary practice to practice, these main benefits will affect a majority of practices to varying degrees. It is important to know and understand how these factors play a role in your practices EMR implementation to maximize the return on your investment.