Electronic medical records: Does the investment make sense?

Modern technology can streamline many office practices and enable physicians to work more efficiently and economically.  Although there may be an initial cost to implementing new technology, the subsequent returns should exceed the costs.  The technological advances that have enabled me to function more economically, more efficiently, and thus, more profitably can be divided into the following categories:
  • Electronic medical recordkeeping
  • Electronic prescribing
  • Accounts receivable and communication with insurance companies
  • Office scheduling
  • Accounts payable
  • Document management
  • Medical information and research

Filing rooms like this will be a thing of the past.

Today I will focus on electronic medical record keeping.  The other topics listed above will be discussed in subsequent blogs.  If you are not already computerized, this may be a particularly opportune time to start.  On Feb. 17, 2009, President Obama signed the American Recovery and Reinvestment Act into law.  This appropriates close to $20 billion to encourage healthcare providers to adopt and effectively utilize electronic health records (EHR).  Physicians are eligible to receive $44,000 for meaningful use of an approved EHR System.

In my own practice, I have been using template-based voice recognition software for all of my reports since 1988.  My colonoscopy reports are produced on an Olympus endoscopic report generator.  My associates dictate via an 800 number to a New Jersey based transcription service, which emails the completed reports within 24 hours.  Since 2000, we have coupled this with a PaperPort-based document management system enabling our office to be completely paperless since 2000.  This has resulted in significant cost savings.  The space formerly utilized by medical record storage racks can now be productively utilized to generate revenues and we no longer pay to warehouse files offsite. We have one employee who spends approximately 35% of his time maintaining patient files.  This work can be readily performed by any of our receptionist staff with a little training, if needed. 

While our EHR fulfills all of our needs, it probably will have to be replaced in order to comply with the new guidelines. I was waiting for official standards to be established before switching to another EHR System.  I have always been concerned about the time required to enter clinical data into any EHR system and found that for our practice, voice dictation worked best.  I am now looking either to modify my current system or purchase a system in order to comply with the HITECH Act, a component of the American Recovery and Reinvestment Act of 2009.

There are at least two motives to the government’s plan.  One is to have physicians adopt electronic medical record keeping and the second is to make patient records generally available and mobile.  There are three criteria in order to qualify it for the government grant and they are as follows:

  • Use of a certified EHR program with electronic prescribing capability
  • Ability to have your medical records electronically accessible
  • Ability to report on the efficacy of your program

The HITECH Act divides physicians into those who accept Medicaid and those who accept Medicare.  Medicare providers can receive up to $44,000 over five years.  This is organized so that those who comply by 2011 will maximize their yield from the $44,000.  This is structured so that in the year 2011 they can receive $18,000, in 2012 $12,000, in 2013 $8000, in 2014 $4,000, in 2015 $2,000.  In 2015 physicians who do not participate will receive a reduction of 1% per year for three years.  At this time physicians who electronically prescribe can also receive up to $6,000‑$8,000 annually from Medicare.

In summary, this appears to be the time to either adopt EHR or make your system compliant with industry standards.  At this time, I cannot endorse any particular vendor, but I recently started working with Allscripts (http://allscripts.com/) to accomplish this.  The Allscripts website is an excellent source of information on HITECH.

Next week:  Look for my article about ETFs.

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