View from the Front Lines of EMR Implementation

Brandon Ousley, Practice Consultant, Halley Consulting Group
September 8, 2011

Electronic health record (EHR) implementation is taking place in hospitals and physician offices across the country. The process of bringing an EHR to fruition is time consuming and costly. It also can bring frustration to hospital executives and physicians - even all the way to the front desk receptionist. If not correctly planned, the training and implementation can make a root canal seem pleasant.

The challenges and tribulations of bringing a certified EHR system to an independent physician practice may seem daunting across the entire resource spectrum. Provider groups from one to 100 are either in the middle of, or soon to be in the midst of implementing an EHR for their practice. The decision to implement an EHR for the independent practice should not be taken lightly. There are many things to consider, and a plethora of EHR options in the marketplace today. The first question that should be asked is, "What's it going to cost?"

Using Medical Group Management Association (MGMA) and government estimates, the cost to implement an EHR is roughly around $200,000 over a five-year period. Many of these costs - maintenance per provider per year ($10,000), reporting per provider per year ($5,000), and additional staff and training ($20,000) are ongoing. With the passage of the HITECH Act, the government has stepped in to offer subsidies to those meeting Meaningful Use qualifications and deadlines. These subsidies, amounting up to $44,000 or $63,750 (depending on the Medicare or Medicaid option) over a five-year period, still leave the practice responsible for the majority of the expense.

A practice looking to adhere to the new guidelines will also need to purchase and implement a practice management system. Electronic practice management systems improve billing, revenue cycle and scheduling, but come at a cost. The efficiency of the office will be vastly improved and a typical practice can usually reduce the billing staff by one to two FTEs (full-time equivalents). These FTEs can then be redeployed back into an EHR maintenance role.

The act of balancing the benefits and financial burden of an EHR is on the minds of all involved. Administrators need to take the lead to make the transition to an EHR as seamless as possible. The physician/patient relationship is what keeps practices running, and if implemented correctly, an EHR can make that relationship grow even stronger.

There is no real challenge to the fact that the use of an EHR is a benefit to all involved, though there is no hard timeline in how these benefits will be realized. At some point, the business itself will benefit through increased productivity and better financial outcomes. System employees will see job satisfaction improvements as everyday tasks such as scheduling, compliance and access to patient information become easier. The quality of care will improve as the repetition of tests decreases. Preventative care will be easier to access, and the management of chronic disease will be easier to track. Last but not least, customers will be more satisfied as the continuum of care becomes a much smoother process.

Brandon Ousley is a Practice Consultant at Halley Consulting Group, which specializes in building successful medical practices and physician/hospital partnerships through a variety of consulting and interim management services.

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