Medical groups need to spend a lot of money to outfit, maintain and manage health information technology
in their practices—more than $32,500 per year in for every single full-time doctor in the practice, according to a recent study.
Furthermore, that total, from a survey of physician groups conducted by the Medical Group Management Association (MGMA) of Englewood, Colo., may not even capture the true costs of technology
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The average spent per doctor on IT by physician-owned multispecialty practices includes $9,405 for the salaries of IT support staff and $23,187 for equipment, maintenance and supplies.
Results from MGMA’s annual survey of 3,100 medical practices, announced August 10, were contained in its 2016 Cost and Revenue Report
Other physician group models, such as those based in hospitals, may have similar costs, but these can be subsumed in the hospital’s IT budget and support services. MGMA’s survey found that costs for IT grew by 40 percent between 2009 and 2015, with the biggest jumps in 2010 and 2011, and they can be expected to continue rising at substantial rates, says David Gans, MSHA, FACMPE, MGMA’s senior fellow for industry affairs. There are good clinical reasons why doctors are becoming more focused on information technology. It plays a vital role in helping healthcare organizations evolve to provide higher quality, value-based care and population health. But the growing cost and complexity of new technologies, new clinical applications and rationales for using them, and a changing landscape of government subsidies and penalties have created a volatile environment where costs will continue to rise, he explains.
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“The days of medical records in the hands of file clerks are long gone. We now have dedicated information technology specialists who increasingly are protecting the practice, for example, from security breaches,” Gans says.
“To remain competitive as independent practitioners, you’ve got to have the bells and whistles, and those don’t come cheap,” adds Rob Tennant, MA, MGMA’s health information technology Policy director.
Physicians are looking not only to avoid government meaningful use payment penalties, but to leverage the technology for improving their practice management. It also has implications for recruiting new physicians, he says.
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“Patients are getting to where they now expect patient portals and the ability to look up their lab results and financial commitments online,” he adds.
As practices prepare for the brave new world
of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and pay-for-performance, it’s only going to get more challenging.
“We see the most sophisticated practices have the highest costs—but also the greatest opportunities for increased revenues, for example, through entering risk-bearing contracts,” Tennant says.
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However, doctors are frustrated with the technology itself, which by and large is not user-friendly (according to whom?) “They are trying to work with their vendors to customize their products, even as the vendors are putting their effort into meeting government mandates,” he says.
Christine Sinsky, MD, an internist in Dubuque, Iowa, and vice president of professional satisfaction for the American Medical Association, believes that the MGMA average seriously understates the actual costs. “We think that’s just the tip of the iceberg, and that actual costs, less easily assessed, are substantially higher,” she says.
There is a 20% to 30% decrease in productivity from the adoption of EHRs that doesn’t go away, she says. There are also costs for physicians who opt to change their practice to part-time because of the demands of EHR, and for recruiting replacements for physicians who retire early because of it.
“And there’s the one to two hours per night I consistently hear about from physicians across the country that they need to spend at home at night working on paperwork. So $32,500 doesn’t really cover the whole picture,” she says.
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While EHRs are not going away, what can physicians and their groups ameliorate their impact on the practice? “For starters, don’t rely on the brochures and videos from the EHR vendors,” Tennant suggests. “Do your due diligence. Reach out to your colleagues who are using these systems.”
He also recommends spending the time and money it takes to maximize the benefits of EHR technology.
“Look at the opportunities to streamline your revenue cycle, such as through electronic funds transfer and insurance eligibility verification. If you’re spending the money, make sure that the system is meeting your practice’s needs,” he says.