advance for Imaging & Oncology Administrators - Nov 2004
Benefits and Barriers to EMR Implementation While EMR allows swift and complete documentation of patient encounters at the point of care, the industry is not yet taking the steps necessary towards implementation.
By Divan Da've
Electronic Medical Record (EMR) systems are among numerous health care applications that have redefined the way medical practices function. The medical care industry is driven by a large amount of accurate information capture and processes. Historically patient information records have typically been stored in paper form, consuming space and increasing the time for delivery of patient care. Cumbersome information retrieval and sharing define the most common problems faced in such an environment.
Gains to the healthcare industry
EMR allows swift and complete documentation of any patient encounter at the point of care. With EMR, patient data is captured and presented in an easy-to-use manner that allows providers and practice staff to navigate through medical histories, allergies, current problems, medications and progress notes. EMR systems are supported with features, which form a backbone in simplifying most medical processes.
For instance appointments can be scheduled and managed over the Web with ease and automated reminders can call patients about upcoming appointments. Electronic prescribing can eliminate 95 percent of adverse drug events and reduce clarification callbacks from pharmacy. Billing can also be managed smoothly with automated charge capture mechanisms, which can allow creation of electronic "superbills" right at the point of care. Clinics can streamline referral processes by organizing both incoming and outgoing referrals via the electronic referral management feature.
Roadblocks to adoption
Given the benefits, which accrue from EMR systems, one would conclude that most medical practices would be keen to move forward with their usage. Surprisingly, as is common with most technological advancements, the medical care industry faces barriers to EMR implementation and usage. Inherent in these barriers is the inertia for the industry to take a step towards allowing technology to improve their work life. Studies by the Institute of Medicine (IOM) report that more than 7,000 deaths and up to 7 percent of hospital admissions are caused each year by adverse drug effects. Information technology in healthcare could substantially reduce these errors, however, ironically the healthcare sector lags behind retail and financial sector in adopting the benefits of technology. Some of the prime barriers to this are outlined below.
- Change is inevitable, but not likeable
One of the upfront barriers is change itself. Medical staff often assumes that they would have to pick up new ways of functioning and get trained and do more work. Doctors also do not want to change the way they practice just to accommodate an EMR; EMR should allow them to practice the medicine in same way. EMR systems overpower these notions by making the system design intuitive by keeping with the way doctors and medical staff functions today.
- Efficiency is not priceless
Yes, doctors do need to invest financial resources in the EMR system. Having said that, the optimal way to look at these costs is a return on investment (ROI) analysis for any system. Don't overreact to price tag; it pays for itself in months and you can recover from your investment. In fact the increased efficiency more than covers the investment. It also makes sense in looking at the opportunity cost of not using EMR technology, which includes the cost of medical errors, under-coding, rejections of claims, high turnaround time for reimbursement, etc.
The costs saved include: reduced chart storage expenses, copying expenses, transcription and labor costs. Contrary to the assumption that because of heavy investment costs only large clinics can invest in EMR systems, there is a range of reasonably priced options specifically for the small to mid-sized clinics.
- Paper to EMR transition
Most clinics face the issue of transferring their paper-based records to the EMR system. EMR providers hence provide facilities to transfer paper records into the EMR system to ease the migration process. Various options such as digitization or scanning of existing records and data entry have been explored to circumvent this problem.
- Am I making the best choice?
Uncertainty or fear of making the wrong choice remains one of the prime barriers. The market is flooded with a plethora of players all wooing the doctor with different products with excellent features. The market also seemed risky with a number of players having ventured in and then shutting shop in the short term. Be sure to systematically dwell in the existing clientele of the vendor, the company background, investment in the market, etc. Further issues of customer support and the vendor's after sale commitment also need to be looked into.
- Other upcoming barriers
Among the other issues that commonly arise is the lack of top management support and financial assistance in implementing EMR systems or a strategic IT plan. Further concerns of data security and confidentiality also hinder the health care industry in EMR adoption.
Where does the future lie?
Medical records are now moving to the Web. Providers and practice staff can securely access crucial patient records through an internet connected handheld, tablet and desktop PCs anywhere, anytime. They will spend less time searching for records while being able to access to any document by any staff member across locations simultaneously. The case for EMR is clear with undisputable evidence that implementation of EMR systems has driven greater customer satisfaction and provider satisfaction. The doctor today needs to spend more time with the patient rather than on documentation, which is the core benefit that the EMR drives.
Divan Da've is the CEO and founder of OmniMD™, a developer of HIPAA compliant Internet-based enterprise clinical solutions, located in Tarrytown, NY. He can be reached ddave@ismnet.com.
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