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EHRs Don’t Support Key Parts of Practice

Posted on June 3, 2013 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Ideally, EHRs make the clinical exams more efficient and effective, ultimately saving or even making more money for medical practices.  But the reality is that they bypass other parts of the patient encounter where much of the costs and inefficiencies are generated, according to a whitepaper by athenahealth, “The Economics of Patient Workflow: Cracking the Code of Successful EHR Design.

As the paper notes, 100 percent of practice revenue is generated by the patient exam. Other stages of managing a practice, such as orders and results management, generate 30 percent to 40 percent of costs but no revenue at all. So having an EHR in place which does little to improve exam efficiency — or actually reduces it — is a dangerous thing to do to a practice.

Worse, as the paper points out, there are some major flaws with typical, software-based EHRs:

* They’re too expensive:  Typical cost is $33,000 per physician plus $1,500 per doctor per month for maintenance.

* They don’t save money because they slow doctors down:  Most EHRs force physicians to do a lot of data entry, much in time-consuming, structured formats.

* They aren’t designed to manage the P4P cycle seamlessly:  With most EHRs, doctors have to dig out the data needed to create pay for performance reports.

* They usually don’t offer an efficient, closed-loop solution to the problem of monitoring paper and electronic orders and results:  Remember, orders and result management generates as much as 40 percent of practice expenses.  EHRs’ failure to make such tracking efficient is a major obstacle for medical practices.

Few EHRs support follow-up work from orders and results effectively:  Most EHRs don’t include built-in management and tracking of patient communications, forcing providers to do inefficient and potentially risky manual follow-up.

The white paper goes on to make the argument that there are several reasons why Web-based EHRs solve these problems, largely by requiring no up front cost, using up less physician time on data entry, optimizing collection of data for P4P programs, digitizing all paperwork and tracking practice results.

Learning from One Doctor’s Experience with EMR – EMR and EHR Interviews

Posted on June 7, 2011 I Written By

John Lynn is the Founder of the blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of and John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

This is the first in a series of EMR, EHR and Healthcare IT interviews that will be done on EMR and HIPAA and EMR and EHR. The full EMR interview with Dr. West can be found on the new EMR, EHR and Healthcare IT interviews website. The following is a summary of that interview written by Kathy Bongiovi.

If you’re a doctor, nurse, practice manager, EHR consultant, CEO or executive of an EHR vendor, etc with EMR experience that’s interested in being interviewed, let us know on our Contact Us page.

In a recent interview with Dr. West, an endocrinologist in Washington D.C. and blogger at Happy EMR Doctor, the doctor discussed his experience in finding an EMR capable of fulfilling the needs of his specialized practice and, at the same time, saving him time. Dr. West discussed the arduous process of going from a failed to a successful EMR system.

His first experience with EMR was frustrating and he ultimately ended his relationship with the vendor. West heard other horror stories regarding failed EMRs and was convinced if he kept trying he would find an EMR that would fit his needs.

Dr. West advises other doctors and healthcare professionals to avoid rushing into any relationship with an EMR vendor and to make sure that when they sign a contract, first make sure the contract has a “satisfaction and money-back guarantee”. He suggests that anyone searching for an EMR, should find a vendor willing to let them try out their product for at least a month with no strings attached. Dr. West adds that the doctor or healthcare professional should also make sure there are not a lot of very specific hardware requirements in case the provider needs to change vendors.

Although some studies suggest a decrease in productivity with EMR systems because of a lack of customization for given specialties, West is not suffering from any of those issues and gives the credit to his EMR, Practice Fusion which is free and web based. The doctor has been able to customize templates to fit his specialty in endocrinology and is therefore able to see patients faster and complete their notes by the close of business. The benefits of customized templates, in his practice, allow “a more uniform approach to common problems, such as diabetes and thyroid nodules.” He goes on to explain that the result is a “well-defined path of questions designed to gather the most meaningful and relevant information” from the patient.

An EHR thorn in Dr. West’s side is his decision to not participate in the government’s EHR incentive plan. He thought he’d pursue the path to meaningful use, but after a great deal of frustration he abandoned his pursuit of the government’s EHR incentive money. West stated he may blog about his inner struggle with this issue. If so, his comments will appear in his blog Happy EMR Doctor.

The interview also touched upon Medicare’s recent practice of eliminating consultation codes and the consequences of this practice. By eliminating codes, Medicare has restricted providers’ ability to bill in certain instances. This has led to Dr. West and others turning away Medicare patients thereby restricting some patients’ access to care.

Dr. West’s EMR success should give all doctors and healthcare professionals the incentive to conquer the EMR puzzle and regain some of their personal time now spent handling and maintaining paper charts.

Full Disclosure: Practice Fusion is an advertiser on this site. However, they didn’t know we were doing this interview with Dr. West. Also, Happy EMR Doctor, Dr. West’s blog, is part of the Healthcare Scene blog network.