Over the last eight years, medical practices and hospitals all over the United States have been abandoning paper charts for electronic ones. In 2004, less than 5% of physicians were using electronic medical record (EMR) systems. That same year, President George W. Bush set the goal that the majority of United States citizens would have an electronic medical chart by 2014. In 2009, President Obama took it a step further and dedicated billions of dollars of incentive money to have all medical charts in a digital format by 2014. These two government moves ushered in the age of EMRs. While a vast majority of the medical world is on board with the changes in theory, the reality is that this has not been a cheap or painless transition for anyone.
In 2008, 41.5% of physicians reported using some type of EMR system. In 2011, that number jumped to 55%,still leaving a substantial portion of the medical community that has not yet made the leap to computerized charting, largely due to both the monetary and time costs. Most practices have thousands of records, and the idea of purchasing an EMR system and then spending the time and money scanning and converting charts is overwhelming, not to mention the time it takes to educate staff and doctors and become comfortable with a new way of doing things. For the 45% who are not online with their patient care, the time is now. The deadline for government incentives for EMR is 2014. Those not integrated and live by 2015 face the possibility of monetary penalties.
But where to start? Choosing an electronic medical records system (EMR) is a daunting task. There are many attributes that must be compared and considered. In today’s market over 900 systems exist. How is it possible to wade through to find the perfect fit for your office? Understanding what you are looking for and weeding out what won’t work for your situation is the best way to start.
1. Narrow the list of vendors down to those that accommodate your specialty. There is no reason to spend any time on a system made for allergists if you are an orthopedic practice. Make sure to be very specific when questioning the salesmen and users.
2. Set a budget, but be realistic. Chances are you do not want a system in the lowest price point. There is a reason it is so cheap. Think about a budget for not only upfront costs, but monthly charges and support fees.
3. Determine which companies meet the requirements for meaningful use. There is no reason to go with a system that is not been upgraded to meet the standard requirements. If the system does not, then your practice will be ineligible for incentives. Educating yourself on what “meaningful” means and what it involves is imperative. Among other things, the system should have the ability to E-prescribe medications, share patient information, and report statistical data. Also consider various certifications and accreditations.
4. The next step is research user satisfaction. Salespeople and testimonials will probably provide a biased opinion, so make sure to read user boards, reviews, and speak to friends and peers who are already using the system. Ask questions and voice concerns. Chances are other physicians will have put time and effort into their choice and are happy to impart what they like and don’t like about their system.
5. Go see the “finalists” actually being used in a practice similar to yours. If you have a small office with only a handful of staff, don’t go to a 15-doctor practice with three offices. Spend a day watching not only how the physician uses the system, but also how the nurses, support staff, and billing office use it. All of these components are important, and none should be overlooked. If possible, also take key staff members to get their opinions. Often managers or insurance specialists will have extra insight into their area of expertise.
6. Understand what will be involved with the training to get your office up and running. Determine a realistic timeline for going live on the new system. Talk to the software company about their scheduling for training, and question peers on how long training took for their offices. Often the seller will give you a “best case scenario” that is not the most accurate. Other users will be more honest about the learning curve and how long it took their offices to be competent in the new system.
Technology has become an everyday part of our lives, and the medical profession is no different. Taking steps to move your practice to EMR now will ensure that you avoid penalties in the not too distant future. The government is dedicated to creating a medical system that is conducive to sharing information. It is best to get on board now, instead of scrambling and purchasing a subpar system at the last minute. Take your time and educate yourself so that the system you choose is the best fit for your practice. Figuring out after the contracts are signed and the charts are scanned that you made a bad decision would mean thousands of dollars and countless man hours wasted. Avoid disaster and choose an EMR wisely.
Jamoom E, Beatty P, Bercovitz A, et al. Physician adoption of electronic health record systems: United States, 2011. NCHS data brief, no 98. Hyattsville, MD: National Center for Health Statistics. 2012.
Hawryluk, Markian. Government Pushes for Electronic Medical Record Standards [newspaper article]. (2004, February 9). Retrieved from http://www.amaassn.org/amednews/2004/02/09/gvsa0209.htm