There is much being said about EMRs and the EMR industry. Health organizations, software companies, and physicians themselves are making contradictory assertions and promises. This white paper addresses some of the myths that have developed over the early years of the industry and, by doing so, explains the basic facts about EMRs, their current importance in the health industry, and their practical use.
Many physicians dismiss EMR technology as the latest healthcare trend—one not likely to last. Physicians think if they ignore it, it will go away, and they certainly don’t want to spend money on something that will be obsolete in a mere year or two!
Fact 1: Technology moves quickly, so it’s probably true that EMR as the world knows it today is not likely to last. However, it is clear that EMR has become far more than a fad: in one way or another, electronic medical records have a firm place in the future of healthcare. EMR technology is developing, improving, and innovating quickly, along with every other technology sector. Today, physicians have a chance to help guide and push that innovation while taking advantage of the innovation that has already taken place.
EMR solutions help physicians to make informed decisions, today, in the here and now. On top of that, they make tracking all manner of data easier, including billing information, which directly affects your bottom line. Besides, with increased governmental support, reduced costs and ease of accessing and sharing information will make EMR software indispensable in the not-so-distant future; most EMR vendors offer free updates with their support costs, so there’s no reason to wait for the EMR software of the future when there are so many benefits to gain here in the present.
With so many EMR vendors occupying the market space in Ontario, all claiming to solve the same problems and fulfill the same documentation management needs, it can be easy to assume that all software products are essentially the same. All vendors allow physicians to record their patient’s medical records digitally: how different can they be?
Fact 2: Until recently, the EMR industry has a lacked a common standard of what actually constitutes and electronic medical record. While it’s true that most EMR vendors may be able to provide clinics with basic EMR systems and document management, every vendor approaches the basic EMR model differently. To some, an EMR meant information captured and stored through data entry. For others, an EMR provided the ability to store scanned images electronically. One approach may work well for one clinic, but not for another.
Over the past number of years, the federal government has stepped into the fray, asking healthcare information technology to set baseline standards for EMRs. This certification effort is in its 4th version. While this certification has provided a new standard for the EMR industry, it has also begun to create an industry of EMR offerings that look essentially the same. In response to this, some physician groups are interested in looking beyond certification as they research and purchase their EMR systems. In order to identify the differences and benefits of each system, physicians need to see the software working; only then, can they begin to see the distinctions among software packages.
With so many EMR offerings out there, it’s easy to get bogged down in the research stage, especially if your clinic doesn’t have a complete vision of what it requires. Many physicians believe this is the way selecting an EMR needs to be and are discouraged from the process as a result.
Fact 3: While choosing an EMR may seem like a daunting task, it doesn’t have to be a painfully difficult one. There are a number of things you can do during the EMR selection process to make the research go smoothly and the decision easy for all those involved in the process at your clinic.
Start your research early and reach out to EMR vendors for preliminary discussions as part of your research. In this process, you’ll be able to determine what is available on the market so you can begin to form some realistic expectations of the system you implement. You can also use this preliminary information to contrast and compare EMRs as you begin to identify functionality information to use when you are ready to look more fully at implementing EMR.
During this time, you’ll be able to develop a clearer picture of what your clinic needs from an EMR system. As you identify what is available, you’ll be able to make lists of features that are required, nice to have, and not needed at all. You may even be able to identify features you don’t want. By using the new understanding of your clinic and the EMR industry, you’ll be able to eliminate a number of offerings right away.
As you’re researching and reaching out to EMR vendors, make note of the responsiveness of the company and the sales team: customer service will become a crucial aspect of your EMR experience, so you want to make sure you sign on with a company that places a high value on their clients’ happiness. One of your first conversations with a vendor should not necessarily be about their solution: rather, look for a company which asks you about the needs of your clinic, what your workflow looks like, and what you’re expecting to get out of your EMR. Without this information, an EMR vendor is going to have a hard time showing you a system that will work for your business.
Once you’ve narrowed your choices down to three or four systems, reach out to the vendors to book a demonstration. Make sure all the decision makers in the clinic are going to be able to attend the presentations and consider each vendor with awareness of the clinic’s needs. Pay attention to how each vendor presents their system: presentations that address your specific work flow will be the most valuable since you’ll be able to see exactly how the system will integrate with your clinic. It has been our experience that, like purchasing a home, when you find the right EMR vendor, you know it. You’ll want to pay attention to the gut feelings of your physicians and clinic managers after you have seen presentations from all the EMR vendors
Knowing exactly what you should expect from EMR vendors as you forge ahead into the EMR selection process will go a long way to helping you make the decision in a quick and painless manner. The process doesn’t have to be long and drawn out if you know exactly what you’re looking for, both in a software solution and in good customer care.
Myth 4: An EMR system is incredibly expensive to purchase.
Contained in this one myth, there are a number of different incorrect assumptions and assertions. Physicians have been told that EMR software is prohibitively expensive. They’ve also been told that the hardware – all the computers and servers they’ll need to buy in order to run the EMR software – will be even more expensive than the software. These are just the obvious costs. Physicians have also been warned of the cost of training their staff and transitioning to a paperless environment. It seems as if everyone believes that a whole EMR system is beyond expensive.
Fact 4: Believe it or not, our CIS system will pay for itself in as little as three years. As you are considering the initial, upfront cost of an EMR system, be careful to ensure you don’t forget to calculate the cost savings and benefits the system will provide for your clinic. Once you consider this aspect of an EMR system, financially, implementing an EMR system makes sense.
That said, it’s true that EMR technology does not come cheaply, and budgeting for EMR technology can be tricky. One common misconception is that the software represents the lion’s share of the expense. In fact, it is just the opposite; the system software is the smallest component of the cost. Rather, the technical infrastructure wuch as computers, servers, network configurations, and training will cost more than the software itself.
Of course, from this knowledge comes the myth that the cost of that infrastructure makes the system prohibitively expensive. However, through OntarioMD funding opportunities for general practitioners and specialists, these costs can be significantly reduced. We recognize that clinics need to keep their costs down in order to take advantage of the financial benefits of an EMR system as quickly as possible, so we work with you to get you the best technical infrastructure for your clinic. We will assess your current hardware in a work flow analysis and, if possible, move ahead with the installation, no new hardware necessary. On the other hand, if your workstations and servers do need to be updated, we will ensure you get the best possible price for new hardware. Where appropriate, we suggest cost efficient leasing as an alternative to purchasing your own hardware. There are a number of third party hardware leasing companies that we have worked with in the past to ensure our clients get the best possible price for their system.
In order to continue to help our clients keep their costs down, here at P & P we offer flexible training models designed to cut costs without sacrificing our clients’ training experience. If desired, instead of training the whole clinic, we will train one ‘superuser’ on all functions, including the most advanced. This user will then be able to train the rest of the staff at the clinic. This training model provides you a fully trained clinic for only a portion of the cost.
If you’re still not convinced that going paperless is the best thing for your clinic’s finances, consider some of these numbers and statistics:
In your paper-based clinic:
• You or your staff spend 38% of your time per day writing notes
• You or your staff spend 30% of your time per day hunting for lost medical records
• Your staff spend approximately 4 hrs. per day managing Rx refills
• It costs approximately $7 to manually create a new chart
• It costs approximately $5 to pull a paper chart
On the other hand, A paperless clinic with P & P’s CIS EMR:
• Saves $1.75 per square foot annually in chart storage
• Saves $.05 Per faxed page
• Saves $.15 per medical history sheets
• Saves $.44 in postage per letter
• Saves $8 per misplaced chart
• $24K Average improvement rate for a reduction in down-coding
On top of the financial benefits, you’ll also see some of these additional cost savings:
• You will no longer need to purchase as much paper
• Your staff will take less time completing simple tasks resulting in improved productivity
• You will no longer have to spend money on maintaining paper records
EMR solutions range from free to tens of thousands of dollars, but keep in mind that the cheapest solution may not be the best solution for your clinic. Don’t allow cost to be your only deciding factor: there are many ways to alleviate the initial outlay of funds. Don’t fall into the trap of implementing a solution that doesn’t work for your clinic, just because it’s inexpensive.
Myth 5: Web-based solutions are best, and less expensive.
Web-based solutions, also known as ASP EMR solutions, have reached a peak of popularity. So many seem to believe they are the future of the EMR industry, especially since they come with a much friendlier price tag.
Fact 5: For some clinics, a web-based solution can seem very attractive and cost effective. For some practices, a monthly payment can preserve cash flow and provide additional stability to financial forecasting. However, when you are considering an ASP service, watch out for hidden costs you may not have been expecting. Due to the high standards and requirements for a client server system, a sometimes substantial hardware investment may be required to fully use the ASP software.
With web-based software, be sure to calculate the monthly cost, the cost of support, and, since your data is not within your immediate control, ask who owns your data. Many EMR vendors will tell you that they, in fact, own your data. If you want to move to another system at any point, you’ll be charged a lot of money to migrate all your data with fees that can reach into the tens of thousands of dollars. If you do choose an ASP vendor, make sure you negotiate these cost up-front; be prepared for your vendor’s reluctance to do so. When it’s all said and done, you may find that an ASP service is not the cost-effective deal you expected it to be.
At P & P, we offer both web-based and local EMR solutions. We will help you calculate and compare up front and ongoing costs, as well as your total cost of ownership, so you can make an informed decision that’s right for your clinic. You may be quite surprised by the results.
Myth 6: Adding an EMR before I retire/sell my business is wasted time and money.
If you’re planning on retiring or selling your business within the next few years, the idea of implementing an EMR system in your clinic may, understandably, seem like a completely pointless endeavour.
Fact 6: If you plan to retire within the next year, then implementing an EMR may not make sense. However, when planning further out (2-5 years), physicians commonly consider only the expenditure of money and effort, while ignoring the benefits that come with an EMR implementation. Don’t make this mistake: if you plan to sell your practice, an EMR may add value to your business for several reasons:
And one other thing to keep in mind: If you implement EMR now, and spend let’s say, $15,000, you stand to make two to three times that amount in government reimbursements over the next few years. This could be a nice sum to add to a retirement account. Don’t let retirement stand in the way of reaping the benefits of an EMR system!
Myth 7: My clinic has specific requirements from an EMR system that are unique to my practice. No out-of-the-box EMR system would work, and customization is outside of a small clinic’s budget.
Your preliminary research may have done nothing but discouraged you in your search for an EMR. Every clinic has unique needs, but it seems as if the EMR industry doesn’t reflect that.
Fact 7: Many physicians find that, at first glance, no out-of-the-box EMR system is sufficient. Specialists may have an even more difficult time, since the EMR industry has been targeting family physicians and general practitioners for so long. Even specialty-only EMRs, such as those designed for pediatricians, may require customization in order to accommodate all that your practice does. Customization can be very expensive and dissuade many specialists and clinics with unique needs from adopting an EMR altogether.
At P & P, we have worked hard to address this issue directly. Our system can be customized through development for a reasonable price, if necessary, but you may find that making drastic changes to the software is unnecessary. Our system can be so thoroughly customized simply through add-ons and user preferences that it can become nearly specialty specific to your practice. We have integrated a number of features specifically for specialists and are constantly listening to our client’s requests as we develop and add further innovation to our software. Specialty-only EMRs are often far more costly because they have a smaller marketplace to sell into, and therefore must make up in pricing what they cannot capture in volume. Don’t rule out a generic EMR system – we can help you determine whether our competitively priced, customizable EMR might make more sense.
Myth 8: Implementing an EMR system is a nightmare.
You’ve heard the horror stories from your colleagues, stories of clinics in disarray, confused staff, cancelled appointments and irate patients. Imagining such an implementation at your clinic can make the prospect of adopting an EMR system completely unattractive.
Fact 8: Choosing the right vendor for your clinic will make all the difference when it comes to your implementation. You can avoid having a nightmare of an implementation by working with a team that invests the time and expertise to make you successful, not only throughout the installation and training, but for the many years beyond with post-implementation support.
As you are discussing implementation with your chosen vendor it is crucially important that you discuss your expectations with them. Are you willing to shut down your clinic for a few days for the implementation and training? This may be the best course of action for some clinics and may result in the smoothest transition with little to no affect on patient care besides a few rescheduled appointments. Or, do you want to stay open throughout the installation so you can continue to provide health care to your patients? While most vendors will be flexible on this issue, some may have their own preferences, so it’s important to have these discussions before you sign so there is no miscommunication between you.
At P & P, we make sure we have these discussions with out clients and work hard to complete the implementation in such a way that requires as little disruption for the clinic as possible. We create a timeline for you based on your practice’s schedule and requirements, and prioritize our implementation and training days from there. Typically, it takes approximately two weeks from signing to implementation, which we will complete at your clinic after-hours if necessary. From there, we train your staff to use the software over a number of days, following a schedule that works for you. You can be fully paperless within a mere month of purchase, and your clinic won’t experience any disruption whatsoever.
Implementation does not stop after the software has been installed and trained, however; as you’re considering EMR vendors, make sure you gain a full understanding of the limits of your future customer support – this is just as important as proper training to your implementation. Without accessible customer service, you won’t be able to trust your vendor to maintain your implementation. In order to get a feel for your vendor’s help and support services, you may want to test-call the support phone line. Ask a few questions to see how the company responds, how they treat you, how easy it is to get a person on the line, their level of knowledge and willingness to get answers for you, and how easy it is to understand them.
Myth 9: My staff will object to EMR software.
If you’ve heard stories about implementing an EMR system, it’s likely your staff have heard stories too, and not all of them will be pleasant stories. You may worry that your staff won’t want to use the new system, and convincing them to change their ways could be difficult.
Fact 9: This myth is purely false. In fact, having a well-implemented EMR system may actually attract staff to your clinic. There’s a simple reason for this possibly unexpected result of an EMR system: by providing your staff with a streamlined way to organize and document patient data, you’re allowing them more time to focus on their passion: providing health care. Of course, this knowledge may not help with your staff who have never used an EMR system and may be daunted by introducing technology into the clinical environment. Make sure they fully understand all the advantages it represents, both for the clinic as a whole, and for them individually.
Myth 10: EMR systems are too complicated to learn.
Any new technology comes with a learning curve. For those who are not fully comfortable using technology in their every day lives, adopting an EMR system can seem like an extremely daunting task, not because of the expense or the implementation, but rather because of the time and effort it will take to learn the system.
Fact 10: Understanding the level of commitment required by you and your staff is paramount for a successful EMR implementation. With any change, especially technological ones, frustration can set in if you are not well prepared for not just what you’ll learn, but how to learn it. When you sign for your chosen EMR system, don’t forget that you are not facing this transition alone: a good vendor will take responsibility for your training to ensure that your EMR adoption is as successful as possible.
Among the things we have learned in our 30 years working in the medical software industry, we have developed a method of training that takes your needs and clinic workflow into account. Without examining how your clinic works, our trainers could teach you every aspect of the system without actually teaching you how to use it.
Once we have completed a detailed work flow analysis, our trainers teach your staff to use the software using that work flow. We train you using real patients and real situations, using the opportunity to migrate some of your patient data into the system at the same time. This gives you a full understanding of how the system works in a real clinical situation with real patients.
Older physicians who are extremely uncomfortable with technology need not give up on the idea of implementing an EMR system either. Our EMR system has a number of tools designed to help those who are unfamiliar with computers. These tools include dictation software, which allow you to speak your medical notes into the system, or templates which guide you through the create of a record. They may help convince even the most technology-averse physician.
Keep in mind, clinics have been transitioning to EMR systems for over 20 years now, and many started out with basic clinical management software even earlier. During this length of time, EMR software developers have learned a lot about how healthcare professionals like to work. The industry has been consistently adapting to the needs of physicians for improved usability. Not only that, but as understanding of the medical industry improves, so do training methodologies, so that you and your staff are well-versed in your new system as quickly and painlessly as possible. The bottom line is that converting to electronic medical records is easier than it seems; here at P & P, we work hard to make sure that your transition is as painless as possible.
Myth 11: An EMR system will slow down my clinic’s productivity significantly.
Many clinics have heard that an EMR system doesn’t actually do one of the main things it claims to do: increasing productivity. In fact, is it possible that an EMR system will actually be detrimental to your clinic’s productivity?
Fact 11: In many ways, this myth goes hand-in-hand with the myth that an EMR is difficult to learn to use. Proper training is a crucial aspect of your implementation and, if it’s not completed and completed properly by your EMR vendor, you may actually see a decrease in your staff’s productivity as they struggle with software they don’t know how to use.
On the other hand, once your solution is fully implemented and you and your staff are properly trained, using the EMR will become faster and easier. Believe it or not, the EMR system will actually allow you to see more patients. Our EMR system provides clinics with improved workflows and faster processes that leverage technology to eliminate tedious, repetitious, and time consuming tasks so you can do more of what you’re passionate about; providing great patient care.
This isn’t the end of improved productivity, however; you may also find that the EMR system helps you improve your billing practices, so you’re able to bill more accurately, more often. This, of course, results in improved revenue, a huge benefit in anyone’s eyes.
The right EMR makes you more efficient, allowing you to see more patients, not less.
Myth 12: Computers get in the way of patient-physician relationships. My patients are going to feel like I’m paying more attention to a piece of technology than to them.
This is a common fear among physicians and health care practitioners as they begin to explore their EMR options. Won’t the computer get in the way during your patient examination? The idea of staring at a computer screen instead of giving your patient your full attention is, understandably, an undesirable prospect.
Fact 12: How the presence of the computer screen affects patient interaction is completely up to the physician. Focusing too much on the EMR rather than the patient is no different than taking written notes rather than giving the patient the undivided attention he or she needs. Ultimately, the benefits of an EMR outweigh the possibility of the software taking away from the patient interaction. In fact, having the rich array of personal health information at your fingertips during patient encounters can boost the doctor-patient relationship. Patients will appreciate being able to see an impressive array of clinical data with a simple click of the mouse and, as a provider, you will be able to direct them more precisely in ways they can improve their own health.
While having technology in the examine room may seem less personal than a simple pad of paper to create written notes, experience has demonstrated that communication between doctor and patient is actually improved by adopting EMRs since information is easily accessible to physicians faster. This translates into more face-to-face time between doctor and patient, giving the physician more of the kind of contact that leads to improved care.
Myth 13: Because my patient’s data will be available digitally, it will be more susceptible to security threats and attacks. My patient information could be hacked.
Viruses, hackers, and leaked data. In the age of the Internet, technology seems so unstable. If email addresses and Facebook accounts can be hacked, how safe can medical records – some of the most sensitive information a person owns – be in technology like EMR?
Fact 13: Medical data stored in an EMR system is far more secure than those stored in a simple traditional paper record. The file folder that contains your patient’s paper medical record can easily be flipped open and the information browsed by anyone who can get their hands on it. Traditional paper files have no restrictions.
On the other hand, EMRs are subject to strict security protocols. These ensure that every record is encrypted against attacks by viruses and hackers and that the file is protected at the clinical level, so that only authorized personnel can access and read the contents. Our system ensures your patients medical records are kept more securely than they would be in paper format. You can set controls on each patient’s record to restrict who is able to access it and, even without these controls set, each time a file is accessed, an electronic record of the event is automatically recorded in the secure history of the file. Patients will always know who can access their medical records at all times.
Not only is your patient data protected from malicious attacks by viruses and hackers, it is also protected from most natural disasters. If your clinic is involved in a physical disaster, such as fire, flooding, etc. your data will be kept safe through off-site back-ups. This means that when you’re clinic is back up and running after a natural disaster, your data will be ready to go too.
As you can see, so many of the things said about the EMR industry are simply not true. On the other hand, some of the myths and misunderstandings about the industry have come from some truth. Some physicians have not had a good experience as they move to a paperless clinical environment, and, as a result, some of these myths have come out of their testimonials. However, as the EMR industry grows and develops, at P & P, we are taking responsibility for these statements and addressing our clients’ needs to eradicate the myths and provide the medical industry with an EMR system that is affordable, easy to implement and straightforward to use.
Download: Are you an EMR Skeptic – 13 EMR myths