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SOAPedia > Implementation Guides > 1. Pre-Purchase Considerations > D. Dispelling the EMR Industry Myths > Myth #3: I am worried about my return on investment.
Myth #3: I am worried about my return on investment.
Table of contents
The days of fee schedule increases, across the board are limited, if not dead altogether. Certainly, there is not a chance that fee increases will keep up with inflation. Any significant fee increases to come will, in some fashion, be tied to what will be referred to as "performance measures." In actuality, in the short term, it will be fee increases for some type of reporting of data beyond ICD/Diagnosis codes and the traditional CPT/Procedure codes included within billing statements.
In many states and regions, physicians are already seeing a 10 to 30% differential in income based on whether or not the practice is participating in "performance" reporting initiatives. If this has not affected your region in 2008, it is unlikely it will not have a significant effect by 2010. Many of these initiatives require practices use an EHR that is certified.
If you are not ready to upgrade to a modern EHR and participate in performance reporting, at least start the process to prescribe electronically. In many states and regions, there are already initiatives in place. The pressures to switch to a certified electronic prescribing solution are only going to increase.
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Ability to code for higher levels of service:(e.g. might result in an extra $136,000 over 5 years)
The EHR should make comprehensive documentation easier so that encounters should be able to be coded at the next higher level of service if under-coding is presently a problem.
(Note: do not overcode. The nature or reason for the visit and resulting complexity and not amount of documentation that can be created shuld determine the level of service.)
A clinician seeing 25 patients daily = then 6 are at higher service level (an extra $15 each).
Then 12 encounters x $15 = $170/day.
Annually 200 days x $170 = $34,000.
The first year is a “wash” because of the time-expense of setting up customizations. So, conservatively, will say that this is not reached until end of year one, so 4 years x $34,000 is $136,000 . If dictation was used before the EHR, also add the saved, related costs.
Specific areas of direct cost savings
Better charge capture.
Better supply management.
Fewer chart retrievals.
Increased revenue.
Less chart photocopying.
Lessened need for chart searching.
Reduced transcription.
Malpractice savings possible in some areas.
When information is paper-bound and maintained in the individual medical record, the prospect of searching through a rack of charts for one or two items of interest (e.g. List all diabetic patients without a recent glycosylated hemoglobin) is almost an impossibility. The ability of a computer to store large amounts of data on each patient and to perform complex, multiple item searches for specific information at high speeds, without errors, and repeatedly over time is the essence of its necessity and its eventual use in medical practice.
In general, high quality care introduces increased responsibilities for health promotion (e.g. immunizations, pap smears, etc.) requiring periodic practice audits. A practice failing to create and maintain a retrievable patient database will find itself disillusioned and disappointed because of unrealistic expectations and vulnerability to superior competition in the marketplace.
Atomatic data collection.
Automatic screening/reporting.
Better capture of charges.
Better chart information for searching.
Better chart information, allows for summarization.
Better communication between primary-specialty care.
Better forecasting.
Better guideline management.
Better longitudinal medical record.
Better outcome reporting.
Better quality documentation.
Better risk management (Less lost data).
Better utilization and review studies.
Clinical alerts and reminders.
Communications (E-mail, scheduling, etc.).
Data, improved ability to determine variability.
Data, improved availability.
Data, improved capture.
Data, improved capture of knowledge.
Data, improved format.
Data, improved outcomes measurements.
Data, improved process.
Data, more useful.
Data, reduce variability.
Data, to alert caregivers and improve decisions.
Data, promotion of direct patient entry.
Easier and more efficient scheduling.
Educational assessment.
Fewer medication errors.
Greater patient confidence.
Hypertext.
Identification of population subsets (preventive care, chronic care, high risk groups, etc.).
Improved access to digital dictation.
Improved access to images.
Improved chart access remotely.
Improved chart access.
Improved community or (patient panel) care.
Improved evaluation.
Improved health care delivery (thus lowered costs).
Improved health care planning.
Improved individual patient care.
Improved legibility.
Improved linking of clinics, hospitals, payers.
Improved longitudinal care.
Improved managerial and administrative efficiency.
Improved patient education/handouts/compliance/good-will.
Improved performance.
Improved quality.
Improved quality of life.
Improved security and confidentiality.
Information when and where it is needed.
Integrated scheduling.
Integrated, multidisciplinary medical record.
Interactive, giving feedback to caregivers.
Intuitive, user-friendly computer interfaces.
Less photocopying of charts.
Less filing into charts.
Less paperwork.
Less time retrieving/hunting/filing charts.
Link to knowledge bases, e.g.meds(PDR, Micromedix) (local, regional, national, global).
Lowered cost.
Make available knowledge bases.
More objective assessment of health care (audit and review).
More patient time.
More rewarding work environment.
Multimedia
Need to migrate information system from a financial to a clinical focus.
Nurse-MD relationship paradigm shift.
Optimized/directed patient care.
Pen-entry.
Potential for increased income (preservation of income).
Promotes universal patient ID.
Reduced malpractice.
Reduced patient waiting for information requests.
Reduced patient waiting for medication refills.
Reduced test/procedure duplication.
Reduced transcription cost.
Referral management.
Replacement of policy and procedure manuals.
Research.
RF-Wireless.
Single entry of information.
Training.
User needs vs. Research needs.
Scheduling.
Speech recognition.
Informational tasks
Increases patient satisfaction
Improved productivity.
Increase efficiency.
Reduce costs.
More audits
Need to document “quality of care.”
Improved customer service
