Free EMR Newsletter Want to receive the latest news on EMR, Meaningful Use, ARRA and Healthcare IT sent straight to your email? Join thousands of healthcare pros who subscribe to EMR and EHR for FREE!

Practice’s EMR Implementation Drove Up Costs For Six Months

Posted on September 28, 2018 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 FierceHealthcare.com 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.

Everyone knows that providers incur EMR-related costs until well after it is implemented. According to a new study, in fact, one medical incurred higher costs for six months after its implementation.

The study, which appeared recently in The Journal of Bone & Joint Surgery, calculated the impact of an EMR implementation on labor costs and productivity at an outpatient orthopedic clinic. The researchers conducting the study used time-driven activity-based costing to estimate EMR-related expenses.

To conduct the study, the research team timed 143 patients prospectively throughout their clinic visit, both before implementation of the hospital system-wide EMR and then again at two months, six months and two years after the implementation.

The researchers found that after the first two months, total labor costs per patient had shot up from $36.88 to $46.04.

One reason for the higher costs was a growth in the amount of time attending surgeons spent per patient, which went up from 9.38 to 10.97 minutes, increasing surgeon cost from $21 to $27.01. In addition, certified medical assistants for spending what time assessing patients, with the time spent almost tripling from 3.42 to 9.1 minutes.

On top of all of this, providers were spending more than twice as much time documenting patient encounters as they had before, up to 7.6 minutes from 3.3 minutes prior to the implementation.

By the six-month mark, however, labor costs per patient had largely returned to their previous levels, settling at $38.75 compared with $36.88 prior to the installation, and expense which remain at the same level when calculated at two years after the EMR implementation.

However, providers were spending even more time documenting encounters than they had before the rolling, with time climbing to 8.43 minutes or roughly 5 minutes more than prior to the introduction of the EMR. Not only that, providers were spending less time interacting with patients, falling to 10.03 as compared with 14.65 minutes in the past.

Sadly, we might have been able to predict this outcome. Clearly, the clinic’s EMR implementation has burdened its providers and further minimized time the providers spend with their patients. This, unfortunately, is more of a rule than an exception.

So why did the ortho practice even bother? It’s hard to say. The study doesn’t say what the practice hoped to accomplish by putting the EMR in place, or whether it met those goals. Given that the system was still in place after two years one would hope that it was providing some form of value.

Truthfully, I’d much rather have learned about what the clinic actually got for its investment than how long it took to get everyone trained up and using it. To be fair, though, this data might have some relevance to the hospital systems that manage a broad spectrum of medical practices, and that’s worth something.

Denmark’s Health System Suffering Familiar EMR Woes

Posted on February 21, 2017 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 FierceHealthcare.com 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.

If you’re trying to navigate the US healthcare system – or worse, trying to pay for your care — Denmark’s alternative may sound pretty sweet. The Danish health system, which is funded through income taxes, offers free care to all Danish residents and EU citizens, as well as free emergency treatment to visitors from all other countries. And the Danes manage to deliver high-quality healthcare while keeping costs at 10.5% of its GDP (as opposed the US, which spends nearly 18% of the GDP on healthcare).

That being said, when it comes to health IT, Denmark is going through some struggles which should be familiar to us all. Starting in 2014, the Danish government began modernizing its healthcare system, an effort which includes developing both new hospitals and a modern health IT infrastructure. One of the linchpins of its efforts is a focus on directing care to fewer, more specialized hospitals – cutting beds by 20% and hopefully reducing average lengths of hospital stays from five to three days – supported by its HIT expansion.

You probably won’t be surprised to learn, meanwhile, that Epic has inserted itself into this effort, winning a $1B project to put its systems in place across 20 hospitals with 44,000 concurrent users. Unfortunately for the Danes, who are starting with a few hospitals in one of the country’s five regions, the effort has run into some early snags. Apparently, the Epic installs at these initial test hospitals aren’t going according to plan.

According to one publication, initial hospital go-lives in May and June of last year have seen  major problems, including errors that have put patients at risk, as well as creating erroneous test reports, results and prescriptions. The Epic systems were also having trouble communicating with the Danish health card, which stores patient information on a magnetic stripe.

The questionable rollout has since caused some controversy. As of August 2016, the local doctors’ union was demanding that a planned deployment in Copenhagen, at Denmark’s busiest hospital, be put off until authorities had figured out what was going wrong at the other two.

At first, I was surprised to hear about about Denmark’s IT woes, as I’d blithely assumed that a government-run health system would have a “central planning” advantage in EMR implementations. But as it turns out, that’s clearly not the case. It seems some frustrations are universal.

I got some insight into this yesterday, when I took a call from an earnest Danish journalist who was trying to understand what the heck was going on with Epic. “Things are going badly here,” she said. “There are lots of complaints from the first two hospitals. And the systems can’t talk to each other.”

I told her not to be surprised by all of this, given how complex Epic rollouts can be. I also warned that given the high cost of Epic software and support, it would not be astonishing if the project ended up over budget. I then predicted that without pulling Epic-trained (and perhaps Epic certified) experts into the project, things might get worse before they get better. “Just hire a boatload of American Epic consultants and you’ll be fine,” I told her, perhaps a bit insensitively. “Maybe.”

When I said that, she was clearly taken aback. Even from thousands of miles away, I could tell she was unhappy. “I was hoping you had a solution,” she finally said. “I wish,” I replied. And I had to laugh so I wouldn’t cry.