August 26, 2010
One Way Of Measuring Meaningful Use Productivity Loss
Written by: John
I think I better just invite BobbyG to join me as a blogger since he’s often contributing essentially great blog posts in the comment. I just have to highlight them. So, here’s one comment that BobbyG offered that talks about the potential productivity loss that a clinic could see if they focus too much on meaningful use and not enough on the business case for implementing an EHR. I think we all know where I stand on this issue. If you don’t, then you should be reading EMR and HIPAA more often;-)
One of my concerns regarding a “stimulus focus” (i.e., an incentive money fixation) in lieu of a broader “business case focus” goes like this, if you will permit what may be a simplistic example:
ASSUME
[1] an average 2 minutes additional MU documentation burden per chart (that’s only 6 seconds on average to navigate to/”touch”/verify/enter each of the requisite 20 measures as needed for each patient during the attestation period);
[2] 100 patients seen per week, 50 weeks per year, or 5,000 charts touched annually;
[3] That’s 10,000 minutes, or ~167 hours;
[4] Multiply by a blended, fully G&A cost-multiplied FTE rate of $40/hour;
[5] 167 hrs/yr x $40/hr x five years = $33,400 MU labor,
exclusive of the FTE burden associated with the additional CQM reporting (“Clinical Quality Measures”). Now, recall that the max provider Medicare MU incentive reimbursement over the 5 years is $44,000 (and that money will be taxable income).
Worth it? Draw your own conclusions. Play with the input assumptions.
Now, obviously, the task (from my REC Adoption Support perspective) is to so effectively re-design workflow as to totally mitigate/eliminate any additional MU documentation burden while streamlining workflow ops more broadly, so that the MU incentive money is neither effectively erased nor appreciably diminished by all of this, and the provider is better off both financially and in terms of care quality and patient satisfaction.
We shall see, I guess.
While my illustrative scenario proffered above is rather simple and to a degree hypothetical, it is nonetheless based to a degree on my own playing around, stopwatch at the ready, in a “sandbox” e-MDs login provided us by the vendor, noting the navigation paths to the various MU “money field” target destinations.
A few seconds here or there, annualized, adds up quickly.
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7 responses to "One Way Of Measuring Meaningful Use Productivity Loss"
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John…
Those of us who subscribe to email alerts benefit from not just your posts … but also benefit from the thoughts and cross conversations of your faithful followers.
Everyone should want to see immediately the next great points from such a wide group of smart people … not just just EMR & HIPAA … but its sister blog EMR & EHR too.
reminds me of something we used to say in my previous life. “If you loose $5 on each customer, you will not make it up in volume”
Excellent post, John! The only problem I have with it is that the “FTE” will usually be the physician, who after so many years of schooling and continual training should earn at least $80-$120 per hour, so your annual figure should be $66000 to $99000 which is at par with what I calculated last year (at least $60000/hour for MU) at MDNG: http://www.hcplive.com/primary-care/mdng-primarycare/PC_Medicare_HIT_mandate
This year I took it a bit further. If we have 800000 physicians, and all decide to become MU, then the annual cost would come out to $60000 x 800000, or $4.8 trillion/year for “quality” which is what MU is supposed to be all about! That’s $480 trillion over the 10 years that dwarfs the cost of Obama’s hated healthcare bill which is to cost “only” a contentious $1trillion.
One article placed the number of physicians that worked in ambulatory facilities (ie the ones that truly quality for MU) at 512,000, so if you only count these, the 10 year cost of MU/”quality” would be somewhat less, or “only” $307 trillion/10 years.
URL: http://ducknetweb.blogspot.com/2010/05/whats-ehr-adoption-rate-look-like-at.html
Gotta go get a beer… I must be old, as I still remember when my father paid me an allowance of 10 cents a week!
Al
Thanks, y’all.
Dr. Borges, yeah, mine was a conservative FTE labor cost assumption, given that many of the MU criteria can be handled by support staff. The overall point remains the same; i.e., additional labor cost, a few seconds here and there, annualizes out to a surprisingly large expense.
I and one of my REC colleagues were over at a clinic yesterday poking around in dummy pt records in their Greenway EHR, doing MU-related navigation. Similar time burdens.
Gonna be interesting.
Thanks DonB for the kind words and everyone else for the discussion. BTW, if you use a feed reader, you can subscribe to the comment feeds for the blog too.
The numbers don’t really look pretty any way you slice it. About time to do another Big Winners post, but most won’t like the list.
Does implementing an ambulatory EHR have to be a drag on Physician Productivity?
Here are some ways you can minimize the productivity impact as you go through an implementation process.
http://www.foxgrp.com/blog/due-diligence-in-ehr-selection-can-it-help-you-preserve-physician-productivity/
Jim,
You’re right that EHR can improve productivity as well. I should write about that!
P.S. It’s great practice in your blog posts to link to high ranking posts on other EMR related websites (like this one). The links out to other high ranking websites along with the links in help you get ranked higher in Google. Plus, if you link to a post on my site from yours then you’ll get a trackback to your post on mine.