EHR: The Profitability Gap

Last week we discussed the loss in productivity that many medical practices face upon implementing an electronic health record (EHR) system. According to a recent MGMA survey, among practices that have “allowed enough time after implementation for physicians and staff to become familiar with the EHR”, over 73% experienced decreased or stagnant productivity levels.

What this really means is decreased profitability levels for your practice. At a time when strengthening and growing the bottom line of your practice is necessary to survive, don’t underestimate the Profitability Gap—the financial impact that varying productivity levels will have on your practice.

As the graphic below illustrates, right out of the starting gate, most EHRs will have a substantially negative impact on productivity levels. However, as a practice gears up for its “go-live” date, a productivity-focused EHR distinguishes itself by gradually increasing physician productivity levels. Once the go-live date is reached, a productivity-focused product like the SRS EHR will continue to steadily increase physician productivity and efficiency levels throughout all stages of implementation; other EHRs, meanwhile, create a painful struggle as the practice tries to recoup lost time, lost efficiencies, and lost productivity.

The EHR Profitability Gap

Furthermore, as data suggests, many practices never reach their original levels of productivity. The difference in productivity levels is depicted in the pink shaded area and has a quantitative value that directly impacts the practice’s bottom line.

A physician’s productivity level dictates his or her ability to generate revenue and affects the profitability of the practice. (It also affects quality of care, since efficient physicians are able to provide better care.) In the graphic above, the gap between the productivity-focused SRS EHR and other EHRs is conservatively estimated at 10%. For a 15-physician practice in which each provider generates revenue of $1 million per year, the Profitability Gap—the revenue that the practice risks losing by selecting the wrong EHR—totals $7.5 million over 5 years.

Concentrating on finding an EHR that is usable and productivity-focused is of paramount importance for your medical practice. Investing time and money into an EHR that will slow down your physicians and exert financial strain on your bottom-line should be avoided at all costs. Don’t fall into the productivity-diminishing side of the profitability gap. Perform your due diligence and find the right productivity-focused EHR solution for your medical practice.

EMR: Don’t Settle for Less

Anytime new technology is introduced to industries, big gains in productivity and efficiency are the end result. The banking and finance industries are prime examples of industries where advancements in new technologies resulted in exponential growth in productivity and efficiency. Unfortunately, the direct opposite has occurred—and continues to occur—when it comes to electronic medical record (EMR) technology and medical practices. Studies have documented the very real, devastating loss in productivity that many medical practices face when implementing an EMR. Productivity losses ranging from 40% to 60% are commonplace, and most practices have to struggle to claw their way back to the same level of productivity they had before their EMR implementation—many times never reaching that point. In any other industry this would not be acceptable, nor tolerated.

Knowing this, why would you accept anything less than an improvement in the current level of productivity within your medical practice? Physicians should expect, and demand, the same leap in productivity that other industries experience from advancing technologies. Physicians enter the medical world to help others—to make a positive impact, raise the bar on patient care, and make things better . . . not to settle for less.

Why, then, when selecting an EMR, would these same physicians even consider a product that actually lowers their efficiency and productivity? Investing in an electronic medical records system that requires physicians to cut their patient load for an extended period of time completely contradicts the purpose of investing in technology. There is no long-term or short-term benefit to adopting an EMR product with such destructive consequences to your medical practice.

So, what do you do? How do you avoid a system that will lead you down the treacherous path of lost productivity and potential EMR failure? Find an EMR that is built on a productivity-focused foundation and insist on being shown the productivity and profitability benefits.

The graphic below illustrates the increase in physician productivity that results during each stage of an implementation of a productivity-focused EMR.

Ability of EHR to Increase Provider Productivity

With a productivity-focused EMR (let’s use SRS EHR as an example), as the practice goes paperless, there is an immediate and considerable gain in productivity. As ePrescribing and Order Management are introduced, significant improvements in communication, patient care, and physician time management result. Using the SRS FlexNote™, physicians continue to document exams as they are accustomed. They have the freedom to dictate, use voice recognition, or to use templates. Whichever option physicians choose, their productivity—their ability to generate revenue and manage their time more efficiently—increases. These are the vital benefits physicians and medical practice decision-makers should expect and demand before investing in an electronic medical record system.

Stay tuned for next week’s post to learn the financial impact that varying productivity levels can have on your practice.

Meaningful Use Workflow: How Are You Allocating Your Resources

Medical practices nationwide are developing plans to allocate their resources to successfully address meaningful use tasks and responsibilities. If you are pursuing the EHR incentives, make sure you are completely confident with your answers to these questions:

  1. Do you understand how the meaningful use requirements apply to your specialty?
  2. Do you know which measures your specialty can potentially exclude?
  3. Is your EHR vendor helping you allocate your resources so you can achieve meaningful use in an efficient and productive manner?

Understanding how each meaningful use requirement applies to your specialty and the impact its successful completion will have on your practice workflow is of paramount importance. Additionally, identifying which meaningful use requirements your practice can potentially exclude will help maximize physician and staff workflow efficiency and help you to obtain the EHR incentives in the most productive manner.

Your EHR vendor should willingly provide your practice with detailed guidance on how to fine-tune your resources and help you allocate responsibilities throughout your practice to ensure a practical meaningful use workflow. Make sure your vendor has the knowledge about the workflow of your particular specialty. For example, ask your vendor for a list of references in your particular specialty and practice size. Furthermore, your vendor should be familiar with the nuances of your practice so that their guidance will help you capitalize on the strengths of individual staff members and teams. Ultimately, the goal is to meet the meaningful use requirements as efficiently and effectively as possible without disrupting your practice workflow.

Take a look at these meaningful use workflow pie charts by specialty. See how your practice can achieve meaningful use in the most efficient manner by capitalizing on the available meaningful use exclusions and sharing the responsibilities among staff members to increase productivity.

3 Tips to Avoid Falling Victim to an EHR Implementation Failure

EHR implementation failures happen far too often—the software doesn’t live up to user expectations, time-consuming data entry is required, physician workflow is disrupted, and, in the vast majority of cases, a sharp decline in productivity occurs. These are just some of the reasons why, according to a recent KLAS report, more than a third of providers plan to replace their current EMRs within the next 2 years.

Avoid Falling Victim to an EHR Implementation FailureThe SRS support and implementation teams—top-rated in quality, service, and commitment—by KLAS reports, recommends the following 3 tips for a successful implementation:

  1. Gain practice-wide support by assigning a physician champion and skilled project manager to formulate the practice’s EHR goals, including the productivity and revenue goals of the physicians.
  2. Make sure a clear implementation plan is designed and followed, including identifying potential hardware issues, understanding the training offered by the vendor, reviewing the implementation stages planned, and finding out who your point/support person at the company will be.
  3. Schedule a weekly update to staff about projects, celebrate milestones, and address problems early before the team is disheartened and reluctant to invest effort in correcting the problem.

Gaining practice-wide support during your EHR implementation, establishing EHR goals for your physicians and staff, and scheduling weekly update meetings with your entire medical practice during your EHR implementation are only a few of many vital tips to help you avoid EHR failure.

Your EHR vendor should provide you all the right tools and knowledge to ensure your success before implementing an EHR system. So how do you know whether you’ll be set up for success?

Be thorough in your research during your EHR selection process. In addition to watching a demo and asking questions, request a comprehensive list of references that are already live on their EHR systems. Make sure the references are in your specialty and have a similar number of providers. Ask your senior staff members and physicians to call 1 or 2 references each, and ask specific questions about EHR usability, support, implementation, and productivity.

This is just the tip of the iceberg of performing your due diligence when selecting an EHR, and how to avoid EHR implementation failure in your medical practice. Come back for future EHR & EMR Insights posts as we dig deeper into the details and the necessary information that will lead you towards a successful EHR experience.

How Quickly Should Your EMR Deliver Improved Features?

Rapidly changing government rules and regulations mean that your Electronic Medical Record (EMR) has to be flexible enough to adapt to these changes—and do it quickly. Your EMR should also promptly and seamlessly deliver the enhancements and additional functionality that your physicians want and need.

What is your EMR vendor’s process for delivering enhancements? With most vendors, you send in a request, and then you wait and hope that it will be accepted and acted upon. Six months to a year later, when the next upgrade comes out, you try it out with your fingers crossed to see if your request was answered. And if it wasn’t, you keep waiting.

The following are some typical responses from disgruntled EMR users that we often hear: (practice names and vendor names are removed for privacy purposes)

“Our multi-specialty group de-installed xxx EHR for two reasons: 1) lack of support; and 2) promised customization for our workflow sheets for the doctors that was never delivered.”

“Our new EHR is a dismal failure. While the software has possibilities, the support provided by the company is not acceptable. Even after direct talks with their CEO and promises by him of improvement, nothing changed. The scheduling module cannot easily handle the practice’s templates and reports do not provide some vital information. After four months of trying to make the reporting package work, one of the support techs let it slip that the module had a flaw, and it would never work.”

So, how quickly should your EMR vendor respond to your requests and deliver the changes that you need? Make sure you get the answers before selecting an EMR.

When performing your due diligence during your EMR selection process, keep the following points at the top of your checklist:

  1. Upgrades and enhancements – EMR features, enhancements, and system upgrades should be performed quickly, if not immediately, by the vendor. Seamless delivery of the upgraded EMR features is critical. Be sure the EMR upgrade will not slow your practice down.
  2. Response time to EMR customization requests – EMR customization requests should be handled as quickly as possible by the EMR vendor. A customer’s needs are a #1 priority and a delay in response time by a vendor’s EMR support team can lead to stunted practice revenue and efficiency.
  3. Functionality of enhancements, upgrades, and customizations – Upgraded EMR features and EMR customizations should be easy to use and always focus on making physicians and staff more productive. Physicians and other healthcare professionals are growing fond of easy-to-download customized applications, like SRS Apps, to make them more productive.

Selecting and purchasing an electronic medical record system for your practice requires extensive research. Performing evidence-based decision-making processes, like those discussed in this EMR Straight Talk blog post, are a must. Don’t be sold the dream. Speak with practices that have implemented the EMRs you are interested in for pertinent information that directly effects day-to-day clinical operations. Knowing how quickly a vendor upgrades their software, handles customization requests, manages turnaround time on the request, and how functional these upgrades and customizations are, can really make a difference in your quest for the right EMR.