If you want to know why many physicians frown or even scowl when they hear the words "electronic medical record," you need look no further than the results of a recent survey conducted by the Physician's Alliance of America.
If you want to know why many physicians frown or even scowl when they hear the words “electronic medical record,” you need look no further than the results of a recent survey conducted by the Physician’s Alliance of America.
When EMR users were asked how much time they spend charting each day, 35% invest an hour or more. One anecdotal comment was, “And I resent this use of my time more than I can say.”
Next, the survey asked about the physicians’ productivity level since using an EMR. Seventy-four percent say their productivity is the same or worse (46%), despite investing a great deal of time and money on the technology.
Brian O’Neill, founder and president of Office Ally, which provides office automation tools to providers countrywide, says the high amount of charting and decrease in productivity is a result of physicians not doing their homework.
Point and Click
O’Neill says that for each condition a patient might present with, such as asthma, guidelines in the form of specific questions to be asked are already programmed into the EMR. And if physicians have different or additional questions they like to ask, they can program those in as well. If done in advance of the patient visit, all the physician has to do is ask the question, then click on the response in the guidelines.
“You see patients quicker if you do your homework ahead of time,” he says. “Where you end up with the slowness is when you’ve done nothing, and then type or handwrite all the questions and answers while seeing the patient.”
O’Neill says that physicians also have a tendency to bite off way too much, especially in the early days of adapting to an EMR.
“Go slow with it for the first two or three weeks,” he advises with regard to gradually integrating the EMR into your practice workflow. “Maybe do two patients in the morning and one in the afternoon until you get the hang of it. Where doctors stop using EMRs is when they say by tomorrow morning we’re going to be electronic. You’ll be there until 10 o’clock that night.”
Paul Caracciolo, chief information officer with Dimension Data Healthcare, agrees with that assessment.
“From my perspective, there is an initial learning curve for the doctors to get up to speed on the newly installed EMR systems,” he says. “After that, there are inherent efficiencies that are realized.”
Clearly, if physicians are spending more time charting and productivity is decreasing, the end result is a negative financial impact on the medical practice. But there are efficiencies with EMRs that can reverse that negative trend.
For example, O’Neill illustrates how when new patients visit a practice, might have as many as three agreement forms—such as financial responsibility, and HIPAA—to read and sign. Those forms then need to be scanned into a PC so they can electronically be uploaded to the patient’s file. But what if the front desk made use of a signature pad?
“With the signature pad, you hand the patient a laminated copy of the HIPAA agreement, and the HIPAA pad says you understand your rights, and they click ‘yes’ and they sign,” O’Neill says. “The same with paying the insurance company. That cuts out hours of staff time a day.”
Another example is having a nurse take a patient’s vitals prior to seeing the doctor. All of that gets entered into the EMR.
“Then, all the doctor has to do is what the doctor is supposed to do,” O’Neill says.
O’Neill explains that whenever he attends a seminar or trade show and physicians stop by his company’s booth to talk about EMRs, he invariably hears the same story.
“They all say, ‘After I got used to it, I would never in a million years go back to paper,’” O’Neill says. “And it’s true. The efficiencies are everything. Can you imagine picking up some of these charts that are 50 pages long and reading through it looking for information, when you can just click, search and find it?”
And, O’Neill adds, physicians really can’t fall back on the excuse that an EMR is too expensive to use, because those efficiencies translate into real dollars saved.
“Instead of having three back office staff, you’ll only need two,” he says. “You just got a $25,000 raise, or $34,000, or whatever you’re paying your staff. The efficiencies are there. Kaiser does it every day of the week, and they’re a five-star plan. If it didn’t work, they wouldn’t be doing that.”