Several years ago, I started thinking seriously about incorporating an electronic health record into my practice.
My staff spent six months searching for an EHR that could interface seamlessly with our practice management system. In the end, we purchased a product from one of the biggest vendors, the very one, in fact, that now owned the rights to our practice management system. It was neither the cheapest nor the most expensive EHR on the market, but the company has been around for a long time and is big enough to provide us with the service we need (customer support, software upgrades, and pharmaceutical updates) for years to come. I covered the cost of the entire system with a 10-year loan.
To determine whether the EHR had a positive financial impact on the practice, my staff and I, with the assistance of my accountant, analyzed seven years' worth of financial data. (During this period, our office overhead costs remained more or less constant, at about 60 percent of gross revenues.)
We began by looking at data from the three years prior to the purchase; then moved to data from the transition year, during which we'd implemented the system and worked out the bugs; and ended with data from the three years following purchase and implementation. For convenience, I'll call these periods one, two, and three.
When we compared periods one and three-that is, the three years prior to purchase and the three years after purchase and implementation-we noted that net revenues had increased by 18 percent. The reason? The EHR helped us code more accurately, leading to higher reimbursements, despite a slight decline in total patient visits. Indeed, in comparing periods one and three, we found that in the post-implementation period we'd coded significantly more established-patient visits with E&M codes 99213, 99214, and 99215. Thanks to our EHR, and a better understanding of the coding system, we were able to document more easily in order to justify a higher level of coding, when warranted.
The EHR also trimmed our expenses. After implementation, we no longer needed our full-time filer, saving approximately $20,000 a year during period three. We also saved on the cost of a transcriptionist, which amounted to $9,600 a year. And after deducting for equipment depreciation, we cut our annual taxes by approximately $7,000.
Beyond its financial impact, the EHR has also enhanced the practice in other ways. For example, we now scan all of our chart data into the computer, resulting in a big savings in time. And, by linking the system with various healthcare Internet sites, which permit us to download valuable information, we've significantly increased our patient education capabilities. Finally, the EHR makes it easier for us to adhere to the latest practice guidelines for various diseases-asthma, congestive heart failure, diabetes, and so on.
A list of must-dos for a successful implementation
Despite our little triumphs, implementing an EHR isn't easy. Among other things, you should be sure to: