What’s your take on EMR?
If your medical organization is like most, you have a love-hate relationship with electronic medical records (EMR). At first, moving paperwork to the computer sounds like a great idea. If your staff doesn’t have to spend long hours taking handwritten notes, making photocopies, and putting papers in file folders, you can all spend more time caring for patients.
At least, that’s how it works in theory. In practice, things are different.
In one recent study by the NIH, EMR only increased free time for physicians by a negligible amount. The study monitored the activities of physicians in specialty clinics before and after they switched from paper records to an electronic system. After the transition, physicians’ time spent with patients only rose from 28.8 to 29.8 minutes. That’s hardly the kind of change that would compel a physician or medical staff to invest thousands of dollars in an EMR system.1
Indeed, in an older NIH study, physicians in clinics that hadn’t implemented EMR were actually spending considerable time with patients. In this study, physicians were found to be spending an impressive 55% of the workday providing face-to-face patient care, while paperwork consumed just 6.5%—34 minutes—of the day.2
Today, the amount of time physicians and their staffs are spending on EMR versus with patients can be staggering. An oft-cited American Journal of Emergency Medicine study recently evaluated physician productivity using electronic medical records in a community hospital emergency department. Physicians in the study were spending an average of 43% of their time on data entry, compared to 28% of their time in direct contact with patients. During a busy 10-hour shift, physicians were making nearly 4,000 mouse clicks.3
Another recent study bears out these findings. Conducted by Virginia’s Health Services Research & Development department, this study set out to measure to what extent patient-centered EMR training would help primary care providers spend less time on EMR and more time with patients during visits. Before the training was provided, the 23 providers in the study were spending 38.6% of each visit on EMR activity. Even after training, EMR continued to consume 38.5% of each visit. Time spent on patient engagement increased only modestly, from 36% to 38.9% of each visit. Meanwhile, mouse clicks per visit declined minimally, from 192 to 189.4
The bottom line? EMR doesn’t seem to be making medical care more efficient, or more patient-centric. 1
Why implementing EMR isn’t just about the benefits
While EMR may not deliver immediate productivity or efficiency benefits to the typical hospital or clinic, it doesn’t seem to be making life noticeably worse, either. So, moving to EMR could be seen as a good thing if it were giving physicians greater job satisfaction and making patients feel more cared-for. “Soft” benefits, after all, are still benefits.
Unfortunately, no matter how much doctors may acknowledge the theoretical benefits of getting rid of paperwork, few of them seem to love EMR. Forbes columnist Steve Denning tells the story of how he recently visited a doctor who apologized for spending half the visit typing notes. The reason for all the typing? The doctor would need to provide extensive documentation of the visit if he ever hoped to be reimbursed by Denning’s insurance company. In the column, the doctor shared his opinion that although electronic records may theoretically be easy to transfer and retrieve, a physician can’t flip through them like paper records—and the process of checking boxes on multiple electronic pages can be tedious and time consuming.5
Nor is implementing EMR a surefire cost-cutting move. According to a recent Health Affairs survey, physicians can expect to lose $44,000 up front when they install EMR systems. Even government subsidies won’t make EMR a financial win for most practices—according to the study, nearly twothirds would still lose money on EMR even after receiving government assistance.6
So, why bother with EMR? Because if you don’t, your medical practice will miss out on incentives— and eventually face penalties. The Health Information Technology for Economic and Clinical Health (HITECH) Act stipulates that physicians can receive $44,000 or more in incentive payments for adopting and implementing certified electronic health record (EHR) or EMR systems. 7
On the flip side, practices that can’t demonstrate “meaningful use” of these systems by the 2015 deadline will face a 1% reduction in their Medicare reimbursements. That figure will rise each year that practices fail to adopt the required technology.8
Like it or not, EMR will be a part of your medical organization in the months and years to come. Are you ready?
How EMR requirements affect your team The looming EMR and EHR requirements are putting pressure on everyone who’s involved with a medical practice—from the chief physician right down to individual patients. Here’s how:
Practice heads. Electronic medical records have to be filled out precisely and processed correctly, or the practice won’t be reimbursed for the services it provides. Unfortunately, filling out EMR online isn’t as simple as ordering a book on Amazon.com. It’s actually a long, complex process in which the decision-maker must check all the right boxes and provide the right descriptions. Rush the process, and you’ll likely get something wrong— putting your clinic’s profitability at risk. Spend more time on the process, and you’ll have less time for patients. It’s a lose-lose situation. Practice heads who don’t want to devote more hours to entering EMR online can address this challenge by hiring additional staff. But entering EMR isn’t a job for just anyone. Finding, training, and retaining reliable staff presents its own challenges—and that’s before you get into the issue of paying salary and benefits. Suffice it to say that EMR can significantly affect the profitability of any medical organization.
Administrative team. The support staff of any hospital, clinic, or practice already work long hours on tasks such as: – Updating patients’ files. – Scheduling appointments and following up with patients. – Communicating with insurance companies to check eligibility and file claims. – Keeping up with receivables. – Ensuring compliance with mandatory record-keeping procedures. Adding extensive EMR work to the responsibilities of office staff can be a bad idea for a couple of reasons. First of all, as we’ve explained, entering EMR online is a timeconsuming, error-prone task—not something that can be squeezed in during a few minutes of daily downtime. Second, many typical medical office staff may be well equipped to answer phones, maintain paper files, and schedule appointments, but they won’t necessarily be equipped to complete detailed electronic records. Put them in charge of EMR, and you’ll need to either invest heavily in training or expect more errors than you’d like.
Patients. Any way you look at it, a greater electronic workload means physicians and their staffs will have less time for patients. Someone—whether it’s the doctor, a nurse, or an administrator—must sit at the computer and fill out all of those fields on the screen. Every man-hour that the clinic’s staff spends at the screen is a man-hour that can’t be spent 4 scheduling appointments, providing medical care, and following up with patients to answer questions and make sure they’re following post-treatment protocols.
Physicians’ families. Let’s not forget that medical professionals have families, too. Under pressure to meet electronic requirements, but wary of building out their office staffs or investing in specialized EMR training, many physicians will tackle the EMR challenge by simply spending more of their own free time entering records online. This approach can take a serious toll on marriages and families—not to mention, the physical and mental health of the physicians themselves.
An innovative way to meet the EMR challenge The potential drawbacks of complying with EMR requirements are obvious. But requirements are requirements. How, then, can the typical medical organization transition to electronic recordkeeping without going over budget or adding headcount—and without risking major errors that jeopardize Medicare reimbursement?
By partnering with a medical scribe service.
Just as corporations that want to avoid building out their server rooms and hiring dozens of new IT staff can engage technical consulting firms to provide virtual IT services, medical organizations that want to get the benefits of EMR without the drawbacks can hire medical scribe services to help keep them in compliance with the electronic data entry requirements of the Affordable Care Act. A good medical scribe service can understand your medical terminology, navigate complex EMR interfaces, and get your data entered correctly so that you have one less worry in running your practice.
When you outsource some or all of your EMR tasks to a third-party provider that specializes in supporting the medical profession, you can:
Reduce the burden of back-office tasks for your entire practice. Enhance your profitability by reducing administrative costs.
Minimize costly errors by leaving EMR to experts who perform the task all day long.
Pay for the services you need on a monthly basis, rather than making a major up-front investment in software, headcount, and training.
Focus more time and energy on providing the best care for your patients—and generating more revenue for your medical organization.
Outsourcing EMR can deliver all of these benefits and more—but only if you choose the right partner. What should you be looking for?
Five signs of a good EMR support partner
As you search for a services provider that can manage your EMR processes, you’ll want to look for more than just familiarity with the requirements of the Affordable Care Act and a track record of accurate data entry. Nsight Global offers more—much more. When you choose Nsight Global as your EMR partner, you’ll benefit from:
1. Our intimate familiarity with medical terminology. Our experts can understand the context in which you’re speaking and figure out the nuances of entering your data into the system. That means we can achieve very high levels of accuracy on all your projects.
2. Our intimate familiarity with EMR interfaces. Let’s face it: EMR systems are complicated and frustrating to use. You didn’t become a physician so that you could spend long hours learning how to use software. But it’s our job to know and use EMR systems, and we’re ready to take this difficult task off your hands.
3. Speedy turnaround times. We understand the urgency of getting your data into the EMR system. That’s why quick turnarounds aren’t a rush service for Nsight Global—they’re just part of the way we operate.
4. Flexibility and scalability. Most EMR service providers only offer fixed-time contracts. We offer contracts as short as 30 days. In addition, we can deliver EMR services targeted at relieving your biggest data entry burdens. For example, many medical practices struggle most with the burden of entering the vast amount of data generated by new patients. They often engage Nsight Global to handle EMR for these patients while keeping the rest of their data entry in-house. This arrangement frees up medical staff to spend more time providing care to patients.
5. Deep knowledge of the medical industry. One of Nsight Global’s founders is a doctor who knows firsthand how challenging it is to run a successful and profitable medical practice in the midst of significant regulatory changes. You’ll benefit from our insights and experience every time you work with us.
6 Request your free consultation today In the wake of the Affordable Care Act, deadlines to embrace EMR and EHR loom on the horizon. Medical organizations everywhere are contemplating the best ways to ensure they’re fully in compliance without bursting their budgets. But that doesn’t mean running a medical practice will soon become a burdensome task. You and your staff entered the medical profession to care for people in need, not worry about electronic records. By outsourcing your EMR activities to an expert partner, you can keep your focus on people without hampering the profitability of your organization. So, don’t just throw money and man-hours at the challenge of transitioning to EMR. Work with a partner that understands your needs and can deliver a solution that’s geared to your individual practice.
For a free EMR consultation with Nsight Global, please call (877) 674-4487 today.