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EMR ROI, Steve Jobs EMR, $1 Billion in EHR Stimulus, and EMR Data Security

Posted on December 11, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Some really interested EMR related tweets in tonight’s round up from around the EMR twittersphere. I’m testing out the new Twitter embed function. We’ll see how it does. It’s a convenient thing, but might need some tweaking.

As always, feel free to follow me on Twitter @techguy and/or @ehrandhit. If you’re on Twitter, let me know so I can make sure I’m following you as well.

Well said! EMR ROI can’t be certified, but it can be measured and planned for.

I wrote a bit about Steve Jobs and EMR before. The icon of Steve Jobs and creating something the way Steve Jobs did is going to be around for a very long time to come.

Over 10k eligible providers and $1 billion in stimulus money. I wonder how many of those 10k providers already had an EMR and how many implemented an EMR to get the stimulus money.

Definitely much higher than I’d have thought as well. Sure, every doctor wants their systems to be secure, but very few make it any sort of priority beyond expecting it to be secure.

What will it cost to do nothing?

Posted on April 8, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Casey Quinlan wrote a really fantastic article about why “What’s the ROI?” is only half the question in healthcare IT. She quickly identifies the real challenge with putting an ROI on an EMR implementation by acknowledging that an ROI discussion quickly leads to a financial discussion. Indeed! The financial side is only have of the EMR ROI question.

I’ve written about the EMR ROI up down backwards and forwards. You have the camp that wants EMR software saying that it provides a great ROI and you have the camp that doesn’t want EMR saying that it doesn’t. The correct answer is that they’re both right. Your EMR ROI is often what you make of it. Not to mention that what you make of it starts with your EMR selection.

In any ROI discussion, I quickly point people to this list of EMR benefits. In EMR presentations, I like to divide that list of benefits into “Guaranteed Benefits,” “Possible Benefits,” and “Debatable Benefits.” In fact, I should probably do the same on that page when I have some free time.

However, Casey, in the article linked above asks a very important additional question, “What will it cost to do nothing?” Then she suggests, “The answer to that question shows the way forward.”

2014 EHR Mandate

Posted on January 13, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I have often found doctors talking about the 2014 mandate for adoption of EHR software. In fact, this post was inspired by a bunch of people searching online for the term “2014 EHR Mandate.” I think that they found my site because I previously did this post about Obama’s goal of Full EHR adoption by 2014.

If I’m remembering right, this was actually just an extension of Bush’s goal of having 100% EHR adoption by 2014. Obama took Bush’s original EMR aspiration and kept it going.

Although, I do have a real problem with people who like to call it an EHR mandate. It’s really not a mandate. A mandate for me implies that you are required to do it or there’s some grave consequence to it. It’s not like you’re going to be thrown in jail for not using an EHR or not be able to practice medicine if you don’t use an EHR (although some have hinted at this idea). Certainly the HITECH act has provided some Medicare penalties that could be considered a grave consequence to not adopting an EHR. Although, when you consider this example of the Medicare penalties it doesn’t look all that grave of a concern to me.

What other penalties are there to not adopting an EHR by 2014?

There certainly are other potential issues with not adopting an EHR that are worth considering:
1. Ability to Sale Practice – I don’t think we know all the details of how this will play out, but be sure that many younger doctors are going to want to purchase a practice that has an EHR. The common thinking I’ve seen going around is that a practice will be more valuable if it is electronic.

2. Government Mandated Reporting – While the government can’t really mandate the use of an EHR, it seems reasonable that the government could require certain reporting be done. Of course, you could manually do this reporting, but at some point the manual way will be much harder than using an EMR where the reporting can be automated.

3. Reimbursement Requirements – At some point the insurance companies are going to require their data electronically. So, if you’re going to want to keep accepting insurance, then you’re going to need to be electronic. I think the insurance companies are still watching and waiting to see what happens with meaningful use before they decide how they’ll approach it. However, you can be sure that they want more data and electronic is the way to make that happen. Of course, you could always go back to cash pay if you don’t like it.

4. Patients – It hasn’t happened quite yet, but get ready for a new patient base that wants their doctor to be electronic. No, you won’t have a “Got EMR?” sign outside your office to market to patients like we once talked about on EMRUpdate. It will come in more subtle things like the ability to schedule an appointment online. The ability to request refill requests electronically. Not having to carry (and possibly lose) their prescription to the pharmacy and then wait for it to be filled. Not having to fill out the same paperwork over and over and over again. Once patients get a real taste for these features, they’re going to be more selective in the doctors they choose to use.

5. ROI for Your Practice – There are plenty of arguments for and against the use of an EMR from an ROI perspective. I personally side on the positive ROI side based on this list of potential EMR benefits. Certainly it takes a smart EMR selection process and a well done EMR implementation to achieve the ROI, but I know a lot of people who’ve saved a lot of money thanks to their EMR. Add in things to come like doctor liability insurance discounts and the ROI will get even better over time. I know one practice who was having tough times financially. Their implementation of an EHR helped to solve some of those financial issues.

I’m sure there are plenty of other reasons that could “force” you to move to using an EMR. Of course, this CDC study on EHR adoption says Physician EMR use is at 50%. Although, in that link I use their study to show that it’s probably closer to 25% EHR adoption. Either way, we still have a long way to go to achieve Obama’s dream of 100% EHR adoption by 2014.

EHRs Don’t Save Money Cycle

Posted on April 15, 2010 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I love the cycle that happens over and over and over again in the healthcare IT/EMR media coverage. Every 3-6 months a new study or article comes out that says that EHR Don’t Save Money. Here’s the one that I just got in my e-mail. At least this one talks about the short term issues, but leaves open the possibility of long term benefits.

Don’t worry though, in the next 3-6 months another study and/or article will be out talking about the amazing benefits of EHR software.

Let’s just cut through the crap for a second and really hit at the core of the issue.

Some clinics have implemented an EMR and seen Amazing benefits (see great EMR ROI).

Some clinics have implemented an EMR and seen little benefit.

Some clinics have implemented (or should I say tried to implement) an EMR and actually gotten screwed.

Every one of those cases has happened. So, if you want me to do a study or article on either side of the issue, it’s really not that hard to do. Just look around and you’ll find all of the above scenarios.

Of course the new voice I hear is that it doesn’t matter. EHR is no longer a choice. The only choice is exactly when, which and how you’re going to implement an EHR. So, that leads to what we really should be talking about…

How do clinics make sure they find themselves in the “Amazing Benefits” group?

P.S. Excuse my use of “crap” and “screwed” all in the same blog post. I just paid my taxes and I think I’m still recovering from it.

EMR ROI Session at HIMSS

Posted on March 9, 2010 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

On Thursday at HIMSS I attended a session called “Implementing and Measuring EMR ROI in the Specialty Practice” by Peter M. Deane, MD. This was the second such session that I attended. I was and am really interested in how practices are measuring the ROI in their clinic.

I found this second session really interesting since Dr. Deane talked about the benefits he received from his EMR and yet, he still wasn’t doing his clinical notes electronically. Yes, it felt a little bit wrong to say that he uses an EMR when he isn’t writing his clinical notes electronically yet. However, what I found really interesting was that he was starting to see a whole laundry lists of benefits from his EMR even though he was only partially implemented.

Honestly, I think that understanding the real benefits of an EMR in your practice is one of the keys to selecting and implementing an EMR. In fact, that’s why I have a whole section talking about the guaranteed, possible and dubious benefits of an EMR implementation in my just released EMR selection book.

Back to the session, Dr. Deane had an interesting point about paper charts. In his slide it said, “Documentation is easy–to do poorly.” This is an interesting point, because I’ve found that EMR doesn’t necessarily take a doctor who is poor at documenting and make them better. However, what an EMR does do is hold people more accountable for what their documenting.

Another key point that was offered in this session was in regards to the EMR selection process, “Decide: None is perfect, nor will the vendors ever by ‘ready’ for some.” I couldn’t agree more. Setting reasonable expectations is key to any successful EMR implementation. Go in with unreasonable expectations and you’re doomed for failure. That doesn’t mean you can’t be ambitious, but you can be reasonable at the same time.

I also loved how Dr. Deane talked about the different types of leadership models in practices. He called them: “Command and control model (large institutional or central tyranny-style practices)” or “Consensus model (fraternity-style practice).” Understanding this dynamic is really important as you work to gain buy in for your EMR implementation.

Another interesting insight he made was that people Fear Change. Ok, that’s not new. However, he clarified that “change means extra work” and “they also fear being left behind.” This is interesting advice during an EMR implementation. I guess the point being that pace of an EMR implementation matters.

Dr. Deane also talked about the value of your EMR vendor customizing the EMR for you. I’ve seen the value of this first hand. It really does empower staff for your EMR vendor to do something for your office. Plus, it’s a real benefit to be able to point to those changes as your EMR progresses. Remember that EMR is a journey and not a one time event.

Here’s a list of other EMR benefits he highlighted:
-3 clerical positions ($70k per year)
-Supplies and less printing ($3,500 per year)
-Enhanced Reimbursement
-Faster A/R turnover time
-PQRI Incentives

Not a bad session. Too bad it was on Thursday just before the closing keynote, so many at HIMSS had already gone home. Lucky for you, I stayed and could summarize it for you here;-)

EMR ROI

Posted on November 18, 2009 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

HIMSS has been collecting stories of EMR success. One of my readers asked for more of these stories as well. So, I figured I’d highlight one that I found that was an interesting look at the ROI he received from implementing an EMR. Here’s an excerpt of the ROI they Glynn Medical Associates out of Georgia saw:

The first three months of going paperless were stressful. However, returns have proven the transition well worth it, with the practice saving approximately/conservatively $200,000/year. Also, one physician in the practice is seeing 33 percent more patients daily with use of the EMR system helping to increase patient satisfaction.

Glynn described that the above benefits came from:

  • Transcription Cost Savings
  • Reduced Medical Records personnel (through natural attrition)
  • Reduced Billing personnel (through natural attrition)
  • Rent Savings (moved into smaller office space)

Stories like this reinforce my belief that there’s a great case to be made for EMR software regardless of EMR stimulus money. Along with the above benefits, check out this list of potential EMR benefits.

Standard EMR ROI Thrown Out The Window

Posted on July 27, 2009 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

One of the things that has bothered me most about the $36.3 billion which is estimated to be spent by the government in EMR stimulus money is the affect it’s had on the decision to implement an EMR. The doctors looking at the stimulus money remind of of Scrooge McDuck from my favorite cartoon ever Ducktales. Yes, Scrooge was the one who had so much money he’d go and swim in it. That part of the story is fictional. The part of Scrooge that’s not fictional is the trance that he’d go into when there was the possibility of more MONEY!! That same look seems to have come over far too many people looking at selecting an electronic medical record.

Certainly there are exceptions, but with the announcement of ARRA’s EHR stimulus money it seems like all of the previous benefits of an EMR have been thrown out the window. All people care to think about is “How do I get that EMR stimulus MONEY from the government?” I think this is a huge mistake and will most certainly lead to major problems in the future.

I’ll continue to argue inform people that an EMR should be implemented on its own merits and not with the hopes of a government windfall of cash.

Let’s step back a second and look at a study done in 2003 about the ROI of an EMR system. Here’s a summary of their findings:

The estimated net benefit from using an electronic medical record for a 5-year period was $86,400 per provider. Benefits accrue primarily from savings in drug expenditures, improved utilization of radiology tests, better capture of charges, and decreased billing errors. In one-way sensitivity analyses, the model was most sensitive to the proportion of patients whose care was capitated; the net benefit varied from a low of $8400 to a high of $140,100. A five-way sensitivity analysis with the most pessimistic and optimistic assumptions showed results ranging from a $2300 net cost to a $330,900 net benefit.

Certainly we could discuss the details of this study, but I think the important point is that there’s an argument that can be made for implementing an EMR that doesn’t include EMR stimulus money. We can’t let the EMR stimulus money put us in a trance where we make stupid decisions. If we do, there will be a huge price to pay years later.