Practice Strategies

Going Paperless: Is EMR Right For You?

Large medical groups and integrated delivery networks have certainly embraced Electronic Medical Record (EMR) technology. But office-based physicians and smaller practices have hesitated.

Sure, the costs and learning curve of building a paperless office can be substantial. But so, too, can the benefits, including:

• More time spent with patients.

• Better efficiency and practice profitability.

• Increased patient satisfaction and compliance.

• Reduced risk of medical errors.

• Improved quality of care.

With more than 200 EMR companies currently targeting small and midsize practices, it’s a buyer’s market. Not only are costs coming down, but practical experience with the systems in a variety of practice sizes and settings has made calculating ROI easier. Even better, health plans and self-insured employers are beginning to offer incentives for doctors who convert to EMR systems.

Do The Due Diligence

Follow these simple steps as you explore whether EMR makes sense for your practice and which products best meet your needs:

Prioritize your needs. While “saving time and improving quality” is a good start for your list, force yourself to drill down to the root causes of time and quality concerns in your practice. Is it that you’re wasting time pulling charts or playing phone tag with the pharmacy? Is under- or over-coding occurring because of imprecise documentation?

Factor in future needs. A good EMR system grows as you do — adding or changing clinicians, adding office sites, sharing electronic records with local hospitals, etc.

Create a simple request for proposal. Ask each EMR vendor to describe in writing exactly how its system will address your needs. Include requests for component-by-component pricing for two or three different product combinations.

Take it for a test drive. Don’t rely solely on demos presented by the salesperson. Stipulate a common scenario (e.g., examining a patient with a specific medical history and specific complaints of your choosing) to put the equipment through its paces.

Get references. Ideally, obtain references from three different physicians within your immediate geographic area — and then visit them onsite to observe the system under field conditions.

Settle on a purchase plan. Your most basic decision will be between an outright purchase (with a set licensing fee per user) and an application server provider (ASP) plan. ASPs involve monthly payments that may continue indefinitely in return for the seller providing the system over the Internet and supplying software fixes and upgrades as they become available.

Drive a hard bargain. EMRs, like cars, come with a wide array of features and options — electronic interfaces that connect EMRs to testing labs, disease-specific templates and guidelines, prescription management tools, etc. Use this leverage to negotiate a good deal on the options and features you want.

Make It Work

It’s a big jump from buying a technology system to actually making it work in the realm of a busy medical practice.

Have at least one strong physician proponent onboard. At least one leading physician in the practice should champion the move and challenge partners and staff to embrace it.

Get a commitment to having doctors enter data. An EMR is like Quicken or Microsoft Money — it only works when data is entered, day in and day out, building up a data repository. In most outpatient settings where staff is spread thin, this happens only if doctors do their share of data entry. It does not make sense to buy an EMR unless a critical mass of doctors in the practice is ready to commit to the process.

Purchase a system suited to the practice’s physicians. Have the physicians — not just the office manager, IT person or CEO — define what they want the new system to do and participate in the vendor selection process.

Look for vendors with a track record. Purchasing expensive technology creates a lock-in effect — the company you start with is the company you stay with. A good way to gauge staying power is by probing a company’s business position (installed base, revenues, number of employees, size of sales force, business partners, etc.).

Plan in advance. Plan for a phased implementation that allows sufficient time for training. Establish clear timelines and milestones. Allow time for technical glitches and establish a backup plan for conducting business when the system is down.

Get tech support for the long haul. A “must” in any purchase is solid system training and readily available technical support to deal with early and ongoing glitches. In an ideal situation, your physician-champion would have this technical aptitude.

For more information about our services to the healthcare industry, Contact:
Maxine Lawyer, Director of Healthcare Services at 972.448.6905.

The articles in this newsletter are general in nature and are not a substitute for accounting, legal, or other professional services. We assume no liability for the reader's reliance on this information. Before implementing any of the ideas contained in this publication, consult a professional advisor to determine whether they apply to your unique circumstances.
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