Meeting Spot Recap: TEPR 2007

The 23rd annual TEPR Conference & Exhibition took place May 19-23 in the Dallas Convention Center in Dallas, TX. This year’s event featured more that 2,000 attendees, more than 200 vendors and exhibitors, and multiple educational program tracks that covered new developments in EMRs and related health information technologies. The educational program included material for physicians in a variety of practice settings (large and small & medium hospitals, ambulatory care, specialty practices), material that focused on issues important to health networks and communities, a “Technology” track that addressed key issues in health information standards and data capture, and a track devoted to information technology in nursing.

As a poorly-reimbursed family physician and the president of AmazingCharts.com, I arrived in Dallas for this year’s TEPR convention excited and nervous, with the goal of comparing electronic medical records and demonstrating my own at the EMRCompare event. One of the high points of this year’s TEPR conference was the complete overhaul of their flawed TEPR Awards. Up until this year, TEPR Awards were based solely on vendor-submitted reports stating what their products cost and what they’re capable of doing. Essentially, the TEPR Awards were just a vendor essay-writing contest offering little value to physicians searching for true objective data they could use when selecting an EMR. (Can you tell I wasn’t one of the essay contest winners?)

This year, however, in a refreshingly bold move designed to regain some of its lost relevancy and to silence much of the criticism regarding their previously biased awards, TEPR introduced EMRCompare, which merged their prior EMR awards and the Clinical Documenting Challenge. The goal of EMRCompare is to objectify EMR usability and affordability by asking vendors to demonstrate a standardized clinical encounter and report their system’s pricing and features.

Furthermore, TEPR has promised to make the process “transparent and permanent, trusted and unbiased”—a pretty bold objective given that TEPR derives much its revenue from EMR vendors, so making them compete with one another risks losing the vendors who offer overpriced or suboptimal products. To succeed in this goal of transparency and objectivity, TEPR is posting on their website the vendor responses on pricing and features, as well as videos of their live demonstration. To show they mean business, TEPR is also providing the ability for anybody to publicly challenge what the vendor has reported—a far cry from the prior closed-door award approach. With EMRCompare, if a vendor is challenged, they can either show the data that supports their claim, or correct their information (and pay a fi ne to TEPR).

This year, the following companies agreed to compete (listed alphabetically): Abelsoft, Amazing Charts, Bond Technologies, e-MDs, iMedica, iSalus, Medical Communications Systems, MediNotes, MedNet Systems, Noteworthy Medical Systems, Pulse Systems, Sage, SSIMed, and Waiting Room Solutions. The 20-minute presentations were timed and moderated by Drs. Edmund Billings, William Rollow, and Thomas Sullivan. While every exhibiting vendor was off ered a chance to compete (for an extra fee of $1,250), only a small percentage of the vendors actually did. According to TEPR, there was a backlash after announcing the new format from many companies over the fact that price was to be a judging point and that 20 minutes was not enough time to truly demonstrate what a product could do. Of course, for the vast majority of harried physicians struggling to get through the myriad of patients just to cover the practice overhead, being able to see exactly what a program can do in a limited amount of time, and the price being asked for the software, is exactly what is needed to truly compare products.

And so, at the end of the two-day TEPR competition, many physicians got their fi rst real chance to compare EMRs, seeing first-hand the variable usability and price for the systems destined soon to be found in all of our practices.

Notable Presentations

ePrescribing and Pharmacy Interoperability Mary Martin, Senior Director of Alliances for SureScripts, explained

how electronic prescribing (or “ePrescribing”) makes sense not only from an economic point of view but also, more importantly, from a patient safety perspective. She noted that the prescription writing and renewal process is “fraught with inefficiencies” under the current system of handwritten prescriptions, faxes, and phone calls, a situation that will become increasingly untenable as prescription volume continues to increase (some estimates say that the annual number of prescriptions written and/or renewed in the US will top four billion by 2010). ePrescribing and computerized physician order entry (CPOE) systems can improve patient safety and increase practice efficiency by reducing or eliminating the impact of errors caused by illegible handwriting, spelling errors, unclear faxes or phone orders, and the use of non-standard abbreviations.

She noted that one study indicated widespread adoption of ePrescribing could prevent two million adverse drug events (130,000 of them life-threatening) per year. She also cited an MGMA study that claimed practices that adopt ePrescribing can save $10,000 per physician per year just by eliminating calls to pharmacies. Further illustrating the time-saving benefits of ePrescribing, Ms. Martin noted that many practices spend four or five hours each day just managing prescription refills, time that could be cut in half (according to a Brown University study) with ePrescribing. Visit SureScripts for physicians.

Getting Physician “Buy-In” of the EMR: Do They Love it or Loathe It?

Paul Schadler, MD, Co-Medical Director of the Health Center at Auraria College in Denver, CO, gave an entertaining and well-received presentation on the factors that can aff ect physician acceptance of an EMR system. Dr. Schadler told the audience that there is a poor understanding on the part of EMR designers of what goes on in a physician’s brain during a patient encounter, and that this lack of understanding is accompanied by an “extraordinary underappreciation” of the cost of cumulative “minor” encroachments on physicians’ time and brain power. This manifests in unwieldy EMR interfaces that result in more work for physicians. He cautioned that physicians should not expect to save much time in the months immediately following EMR implementation (unless they did a lot of dictation and billed poorly prior to adopting the EMR).

In order to promote physician acceptance of an EMR system, Dr. Schadler stressed the importance of developing and communicating a clear understanding of the goals and expectations for the system, involving physicians in the selection and implementation process, investing in training, and to “let people do it their way” while they’re still learning the ins and outs of the system.

EMR Road Show

Couldn’t get to TEPR this year? No worries; the EMR Road Show^™ gives you a chance to catch up on all the latest EMR developments and implementation strategies. Attendees will learn how to select the system that best fits their practice, how to adopt an “outcome-oriented approach” to planning an EHR implementation, how to measure progress and success, how to maximize ROI, and much more. Visit for program details and a schedule of upcoming dates and locations.

Dr. Bertman is a Clinical Assistant Professor of Family Medicine at Brown University and president of AmazingCharts.com, a leading developer of Electronic Health Record (EHR) software. He is in private practice in Hope Valley, Rhode Island.