Close-up: Electronic Medical Records

n.

Electronic medical record: A term used to describe a patient's medicalrecord in a digital format.

While much of the controversy surrounding electronicmedical records (EMRs) has centered onthe issue of patient confidentiality, the cost ofimplementation to the medical community and potentialsavings to that same environment is a major issue.

What Will EMRs Cost?

Health Affairs

Recent studies have shed some light—albeit in ballparkterms—on the costs of setting up EMR systems. Onestudy, published in the journal (September/October 2005), revealed that initial EMR setup costs at 14small physician practices averaged $44,000 per full-timeprovider, with an additional $8500 in annual costs tomaintain the system.

The American Journal of Medicine

While the most comprehensive study was published in(Vol. 114, April 1,2003), the following are recent figures for the averagebreakdown of costs, estimated by EMR Experts (www.emrexperts.com):

At present, physicians and physician practices bear thecosts of implementing an EMR system, but that couldchange. Several pieces of legislation are pending thatwould provide financial assistance to doctors who startusing EMRs—including legislation proposed by SenatorsBill Frist and Hillary Clinton authorizing up to a $15,000reimbursement. Passage of this and related legislation is,of course, still up in the air.

What Are the Savings?

Health Affairs

The same study of 14 small physician practices inrevealed that, on average, the practicesrecouped the cost of EMR system implementation in 2¹/²years. That meant a savings thereafter of approximately$23,000 per provider per year based largely on improvedefficiencies.

The American Journal of Medicine

cost-benefit studyanalyzed the financial effects of EMR systems in ambulatoryprimary care settings using the traditional paper-basedmedical record for comparison purposes. The studyrevealed an "estimated net benefit from using an EMR fora 5-year period" of $86,400 per provider, not far off of theresults of the study of 14 small physician practices.

Legislation proposing a standardization of EMR systemsis being bandied about, and other obstacles—including high initial implementation costs and the disruptiveeffects on physician practices during implementation—need to be addressed. But initial studies demonstratethat the implementation of an EMR system in aprimary care setting can result in a positive return oninvestment.

Benefits of EMRs

Health Affairs

A study published in (September/October 2005) indicated that only 12% of practiceswith five or fewer full-time physicians hadfunctional EMR systems. However, another 34%said that they planned to implement an EMR systemby year-end 2007. Some of the benefits thosepractices could realize include the following:

•Improved patient care. The reduction inmedical errors and the availability of accuratepatient information has been documented. Thiscan have a positive impact from the physician'soffice to the operating room.

•Accessible patient data. Patient data is asmobile as the patients themselves. Whetherpatients move to a new town, or are simply travelingfor work or on vacation, medical informationis readily available to primary care physicians andspecialists.

•Increased patient time. Health care professionalsspend as much time performing administrativetasks as they do with their patients.Increasing patient "face" time can lead to improveddiagnoses and treatment regimens.

•Better communication and collaboration.Medical records made available throughsecure portals will empower patients to managetheir health more effectively, and should lead toimproved communication and collaboration withhealth care providers.

POP QUIZ

Health Affairs

1) Studies published in reveal that EMRsetup costs for small physician practices average

1. $42,000
2. $44,000
3. $46,000
4. $48,000

2) Proposed legislation authorizes EMR setup reimbursementof

1. $5000
2. $10,000
3. $15,000
4. $20,000

The American Journal of Medicine

3) According to ,the net benefit per provider from using an EMR systemfor a 5-year period is estimated at

1. $84,600
2. $86,400
3. $88,400
4. $90,000

4) What percent of practices with 5or fewer full-time physicians hadfunctional EMR systems in 2005?

1. 8%
2. 10%
3. 12%
4. 14%

5) The benefits associated with EMRs include

1. Improved patient care
2. More time with patients
3. Improved patient communication
4. All the above

Answers: 1) b; 2) c; 3) b; 4) c; 5) d.