MediNotes Research Uncovers Primary Hurdles to Electronic Medical Record Implementation by Small U.S. Practices

WEST DES MOINES, Iowa -- MediNotes Corporation, a provider of electronic medical record (EMR) systems for small- to mid-size medical practices, today announced the findings of research that was conducted by MediNotes' vice president of corporate development, Jack Callahan. Based on the implementation of electronic medical record systems by more than 4,300 small U.S. medical practices and 18,500 individual users, the report concludes seven distinguishable misconceptions that cause small U.S. medical practices to reconsider deploying an EMR solution.

Practitioners in small medical offices face many pressures in today's cost-conscious world. With decreasing reimbursements, rising costs in all aspects of medicine, and increased pressures such as pay for performance and other results-based measures, practices spend far more time managing their practice than ever before. Finding ways to streamline the business and operate more efficiently has become imperative. This is especially true for small practices with limited resources.

"Over the last decade, our experience with thousands of physicians in small practices has helped us identify seven categories of obstacles that practices encounter while tangled in the EMR conundrum," said Callahan. "These seven hurdles encompass most of what practice managers deal with when trying to decide whether or not to move ahead with EMR deployment. Because each practice is unique in its specialty, geography, resources, mission for the practice and perhaps other variables, these seven hurdles come in differing proportions."

The Seven Hurdles

1. Cost/Economics

The research concludes that there are several negative perceptions associated with the costs of implementing an EMR based on feedback from thousands of U.S. doctors. These misconceptions include; they cost too much, the benefits don't outweigh the costs, revenue is lost due to learning curve, and annual costs are too high. This is a result of looking at the price tag of EMRs for large healthcare settings. It is widely estimated that the average cost to purchase an EMR is between $20,000 and $35,000 per provider, plus as much as $10,000 per year in maintenance charges. These figures are grossly exaggerated when comparing the actual costs and maintenance for a small medical practice, which usually costs less than $20,000 a year for an EMR.

2. Productivity

A decline in productivity is the biggest hurdle that many small practice physicians fear when considering an EMR. Increasing costs and declining reimbursements leave many small practices in an economic crunch. The only way to stay ahead, for many, is to see more patients. But many fear that using an EMR will slow them down and result in seeing fewer patients. In fact, the main cause of failed EMR implementations is poor preparation, which includes poor planning, lack of commitment and training in the EMR process. Deploying an EMR will probably produce greater results. These results include speed and accuracy of patient encounter notes, legibility and confidence, and a potential increase in patients.

3. Fit

Physicians who have practiced for a number of years get accustomed to working in a certain way. There is a certain "hum" of familiarity in the methods, processes and systems that are used every day. There is often a "we do things differently" mentality resulting in physicians assuming that an EMR will either force them to change their current, comfortable processes or create such chaos that the staff will resist the change. Doctors are often reluctant to use new technology because doing so requires them to adapt to the software, as opposed to the other way around.

As small-practice physicians continue to feel the pressure and need to deploy an EMR, the issue of "fit" is yet another obstacle they must overcome. The key is to envision how the issue of "fit" is perceived once EMR implementation is achieved and the practice running smoother.

4. Quality

A transition to electronic records will also encompass several new office processes. As with any transition, there are bound to be reasonable questions that conjure up feelings of doubt and uncertainty. What if medical records are lost? What happens if the system crashes or is unavailable? Will I still have to keep my paper records? Although these questions are natural, in reality an electronic medical records system is far more secure and stable than paper records ever could be.

5. Resistance to Change

Most humans are resistant to change in one way or another; even if the outcome of the change will have a positive impact on their life. This element of human nature cannot be underestimated in the implementation of an EMR. With EMR, "change" is markedly for the better. Practices must continue to envision the benefits of deploying an EMR and all that will be achieved once it is installed in the practice. Many tedious tasks will be eliminated; lost, missing and un-organized documents will be minimized; productivity of the office as a whole will increase; the office will feel and look more contemporary; costs will be lowered; and potential for revenues will increase.

6. Dissonance

Human nature represents the sixth hurdle. It's perfectly natural to second-guess any large decision in our lives. In the case of an EMR, one may wonder, did I choose the right one or did I spend too much money, or is EMR the right decision for my practice? But with so many products to choose from, and many of them certified by the same CCHIT (http://www.cchit.org) process, there is plenty of room for dissonance to become an issue. Continuing to maintain a clear vision and move forward will lead to increased pay for performance, reimbursement, automated processes, as well as the assurance that all your records are safe, legible and accessible.

7. Implementation

Once the decision to purchase an EMR is made, many small medical practices believe being fully operational is just one quick step away. When in actuality, implementation is the step that is most often taken for granted. Concerns about implementation and the process of fully deploying an EMR are one of the major hurdles in making the decision to move forward for a practice. Implementation can be eased depending on the EMR system that is chosen and the training that goes along with that particular EMR.

Source: MediNotes Corporation

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