Here is a quick look at some of the other articles recently posted on some of the other HealthcareScene.com websites:

EHR and EMR Videos

David Collins of HIMSS Discusses the Course of Global Health at the 2011 mHealth Summit- David Collins, Senior Director of Professional Development at HIMSS, speaks at the 2011 mHealth Summit about HIMSS’ involvement in this year’s Summit, and about how HIT X.0 is affecting the course of Global Health.

Cerner Smart Room Technology Overview Video- An updated view of Cerner’s Smart Room technology. The Cerner Smart Room incorporates technology and workflow software to improve consumer care and clinician efficiency. The Smart Room is powered by CareAwareTM device connectivity architecture.

EHR and EMR Screenshots

These three posts provide numerous screenshots from the DentiMax Dental Practice Management Software.  Are there special considerations for a dental practice as opposed to a regular medical practice when it comes to EHR/EMR/PM?

Screenshots from the DentiMax Dental Practice Management Software
More Screenshots from the DentiMax Dental Practice Management Software
Appointment Book Pro Screenshots from the DentiMax Dental Practice Management Software

Smart Phone Health Care

How to Get Physicians Onboard with mHealth- No matter how great an app or device may be, it will be difficult for any developer to be successful if they don’t get some level of buy in from physicians in general.  People will always resort back to their physician when it comes to the quality of medical products.

Axial’s Care Transition Suite Wins “Ensuring Safe Transitions from Hospital to Home” Mobile App Challenge- In a recent online discussion I had concerning an article I recently wrote, the point was raised that for an app or device to be successful it must fulfill a need.  While I don’t think that it is absolutely essential to success, it certainly makes the path to success much more realistic.

I received the following email from a reader of this blog:

I am the manager of a 2 physician, 2 nurse practitioner practice with an 11 bed sleep lab. We purchased our EMR in 2006, without much research, because it was compatible with our billing/scheduling program. It is grossly time consuming. Just entering a problem list takes 5 steps (for each disorder we are entering). It will not create notes as many EMRs do. We dictate notes to a transcription service and they are uploaded as documents. Basically it is a non-interactive storage unit, much like our paper charts were, except more time consuming. The company has basically told us that they will not be changing the system. The doctors and NPs are nearing revolt at this point because of the time that they spend trying to use this system.

What is your point of view on finding a new EMR? What would the time and mental repercussions be? Is it possible to coordinate billing systems and EMRs from different companies?

My reply was something I thought many on this blog would benefit from:
Thanks for sharing your experience. Unfortunately, it’s a common one.

The good news for you is it sounds like the notes in your current system is basically a document management system that stores your transcriptions electronically. This bodes well for you if you decide you’d like to move to a new EMR system. I say that because it is likely that you’ll be able to get these documents out of your old system and import them into a new EMR system so that your old EMR records are still available in the new EMR. Many EMR companies will work with you on doing just this.

If your current EMR system is worse than paper, then it sounds like change is likely a good choice. What I think you’ll find is the lessons you’ve learned from this first implementation will help you in your next EMR selection and implementation. It’s unfortunate you had to pay that price, but now that you’ve learned you might as well use it to your full advantage, right? In business they call it a sunk cost. It’s time and money already spent. You should base your decisions on changing your EMR on the time and money you’ll have to spend going forward and not costs which you’ll never get back.

It will take some time and money to fix it. However, those people who dislike your current EMR might be ready to commit the time and money needed to find a good EMR to replace what you’re using now. I will also say that I think unhappy workers is worth spending a lot of time and money to fix. An EMR should not start a revolt.

My only caution for you is that you need to take a real serious look at your clinic and ask an important question: Is it the EMR that’s the problem or is it something about our workflow/clinical environment/policies/culture that is the real problem with the system? Obviously, if it’s the former a change of EMR would be good. If it’s the later, then you might as well not change EMR software until you fix those other issues. I’ve often said that implementing an EMR just exacerbates any problems or weaknesses that exist in a clinical environment. It brings them to the surface and makes them hard to ignore.

Yes, there are a number of EMR companies that will work with your current Practice Management System (PMS). I’m someone who believes that if you’re very happy with your current PMS and the reimbursement that you’re getting from it, then it’s certainly a reasonable option to stick with your current PMS and interface it with an EMR company. In fact, there are some companies that are only EMR companies and then interface with various PMS systems. Their philosophy is that they should just focus their time on making an excellent EMR and not divide themselves between EMR and PMS software creation. Basically, they let another company focus on making an excellent PMS (or they’re are already excellent PMS systems out there). One example of this is Medtuity which is where I learned some of these principles. As I look at their product, I can see the advantages of focusing on being the best EMR and not being distracted.

Just know that there are costs associated with managing/supporting an interface between your EMR and PMS. Plus, there are some advantages to having the two integrated. You should weigh those out as you select a new EMR.

This was kind of fun. If you have a question you’d like me to answer, send it to me on my contact form and I’ll see about making it a future blog post.

I received an email not too long ago from a medical billing company who talks about the crazy costs associated with medical billing. In their email they offered the following statistics on the costs of medical billing.

The statistics below represent industry averages taken from the MGMA.

Claims Rejected on 1st Submission – 30 %
Underpayed Claims – 20%
Gross Collection Rate – < 60%
Preventable Denials - 90%
Denials that are Recoverable - 67%
Average days in A/R - 52.32
Cost per claim - $5-$7
Cost per FTE physician - $30,000-$60,000
Cost of billing operations - 18-22%
Cost of Billing Personnel - 58-62%
Cost of Technology/ Practice Management Solution - 18-22%

Source: Avisena whitepaper

I must admit that billing is far from my expertise, but it’s a well described necessary evil for almost any practice. Plus, the better you do it, the more money your clinical practice can make.

Of course, my question is how did implementing an EMR in your clinic either help or hurt these various costs? Were you better able to process claims, because the charting was done electronically and the coding done at the time of visit? Were you able to process claims at a higher rate because your documentation was more complete using an EMR? Could you more quickly process denied claims because it was electronic? Did you need more or less employees to do your billing after implementing an EMR?

I guess it would also be important to know if you decided to go with an integrated Electronic Medical Record and Practice Management System or if you tried an interface between your legacy system and a new EMR system.