Implementing an Electronic Medical Records System-You Can Do It

Implementation of an electronic medical records (EMR) system is neither a fast nor a simple process. For some practices it takes years to get physician buy-in, make a decision, train staff and convert to digital records.

Texas Ear, Nose & Throat Specialists in Houston looked at EMRs for three years and almost bought products on two separate occasions.

We backed off, like on the eve of the wedding, said practice administrator Louise Eddy. No matter how good the product looked, if we couldn’t make this work for our physicians, we knew it would fail.

Finally, the 25-physician practice found an EMR system that provided an integrated audiology component and an ENT-customized progress note that was easy to edit and complete. If it’s too hard, you can’t get anybody to do it, Ms. Eddy said.

Her practice and others have also discovered that an EMR system is not cheap. While some physician groups have paid per-physician fees of $5,000 to $18,000 to implement the system and $1,000 to $3,500 annually for customer service, a 2005 study in the journal Health Affairs puts the cost even higher. The journal estimated $44,000 per physician in initial costs and $8,500 per physician in yearly maintenance expenses.

Numerous studies have shown that cost is the biggest reason for low adoption rates. And yet, most practices who successfully implement an EMR system report a return on investment (ROI) anywhere from a few months to a couple of years. On a national level, an estimated $80 billion could be saved annually with an EMR system, according to studies by Health Affairs and the RAND Corporation.

You have to look at the expense over time, said Ronald Kuppersmith, MD, of Texas ENT & Allergy in College Station. A lot of people look at the numbers and say ‘this is a lot of money; I don’t make that much.’ But you have to compare it to your existing costs. In our situation, just by eliminating dictation, we paid for the software licenses.

D. Thomas Upchurch, MD, Chief Medical Officer of the EMR company AllMeds, said most practices see a return on investment in six to seven months. If somebody’s not that busy in their practice, they won’t make money on the EMR initially, he added. It’s done by saving costs at several levels and helping the doctor see one or two more patients every day. What every group should do is run a very careful return on investment analysis before putting in a system.