Difference between revisions of "EMR Benefits and Return on Investment Categories"

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<ref name=”Hillestad 2005”> Hillestad, R., Bigelow, J., Bower, A., Girosi, F., Meili, R., Scoville, R., & Taylor, R. (2005). Can Electronic Medical Record Systems Transform Health Care? Potential Health Benefits, Savings, and Costs. Health Affairs, 24(5), 1103-1117.</ref>
 
<ref name=”Hillestad 2005”> Hillestad, R., Bigelow, J., Bower, A., Girosi, F., Meili, R., Scoville, R., & Taylor, R. (2005). Can Electronic Medical Record Systems Transform Health Care? Potential Health Benefits, Savings, and Costs. Health Affairs, 24(5), 1103-1117.</ref>
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===Billing Accuracy===
  
==Billing Accuracy==
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The benefits for small to medium private practices that have implemented EMR systems integrated with the practices' billing and prescription systems, can be increased efficiency and accuracy thanks to automatic coding leading to improved profitability. "Since installing the EMR, Medicare has audited only one of my charts. I had billed out as a level four and Medicare said it should have been billed as a level five, which, in essence, said that we should have been paid more. My EMR system gave the chart a level four and I believe it was right.”"Since adopting an EMR system, my practice receipts have increased about $4,000 per month."<ref name="Sonnenberg 2007">EMR ROI: A Pennsylvania family practice's investment in an EMR pays off three-fold NP Communications, LLChttp://tmclibrary.summon.serialssolutions.com/search?s.q=tierney+m+j#!/search?ho=t&l=en&q=EMR%20ROI:%20A%20pennsylvania%20family%20practice's%20investment%20in%20an%20EMR%20pays%20off%20three-fold%20NP%20Communications,%20LLC.</ref>
  
The benefits for small to medium private practices that have implemented EMR systems integrated with the practices' billing and prescription systems, can be increased efficiency and accuracy due to automatic coding leading to improved profitability. "Since installing the EMR, Medicare has audited only one of my charts. I had billed out as a level four and Medicare said it should have been billed as a level five, which, in essence, said that we should have been paid more. My EMR system gave the chart a level four and I believe it was right.”"Since adopting an EMR system, my practice receipts have increased about $4,000 per month."<ref name="Sonnenberg 2007">EMR ROI: A Pennsylvania family practice's investment in an EMR pays off three-fold NP Communications, LLChttp://tmclibrary.summon.serialssolutions.com/search?s.q=tierney+m+j#!/search?ho=t&l=en&q=EMR%20ROI:%20A%20pennsylvania%20family%20practice's%20investment%20in%20an%20EMR%20pays%20off%20three-fold%20NP%20Communications,%20LLC.</ref>
 
 
== Improving Patient Care ==
 
== Improving Patient Care ==
 
[[EMR Benefits: Healthcare quality]]
 
[[EMR Benefits: Healthcare quality]]

Revision as of 19:52, 16 September 2015

The sections below detail the benefits, costs, and barriers in evaluating EMR implementations. Selecting, financing, and launching an EHR system is difficult.

Informational

EMR Benefits: Informational

Security

EMR Benefits: Security is an advantageous attribute which comes with EMR systems. Centers for Medicare and Medicaid Services (CMS) published a privacy, security & meaningful use guidelines which computer systems that store patient information need to conform to imply to HIPAA privacy guidelines. [1]

Environmental

EMR Benefits: Environmental positive impact through Electronic Health Records has the potential to improve the environmental footprint left by the health care industry. [2]

Medical Education

EMR Benefits: Medical education

In a teaching facility EMRs can be a very useful tool for medical education and training. EMRs can be used to monitor how much time each trainee spends with patients and therefore their clinical experience in terms of patient diagnosis and procedures can be tracked and reported to enable optimization of workflow for both trainee and training programs. [3]

In addition the use of EMRs in a teaching environment allows trainees access to the most up to date information. “Point-of-care education accessed via CDS allows for easy access to relevant and up-to-date medical literature from which students and residents can draw to formulate diagnosis and management plans".[3]

Financial

EMR Benefits: Financial

"Implementing an EMR system could cost a single physician approximately $163,765. As of May 2015, the Centers for Medicare and Medicaid Services (CMS) had paid more than $30 billion in financial incentives to more than 468,000 Medicare and Medicaid providers for implementing EMR systems. With a majority of Americans now having at least one if not multiple EMRs generated on their behalf, data breaches and security threats are becoming more common and are estimated by the American Action Forum (AAF) to have cost the health care industry as much as $50.6 billion since 2009." [4]

Some of the ways that EMR systems can cut healthcare costs are due to savings based on "time-consuming paper-driven and labor-intensive tasks":[5]

  • Reduced transcription costs[5]
  • Reduced chart pull, storage, and re-filing costs [5]
  • Improved and more accurate reimbursement coding with improved documentation for highly compensated codes [5]
  • Reduced medical errors through better access to patient data and error prevention alerts [5]
  • Improved patient health/quality of care through better disease management and patient education [5]

There are few comprehensive estimates of savings from Health Information Technology (HIT) at the national level. At 90 percent adoption, it is estimated that the potential HIT – enabled efficiency savings for both inpatient and outpatient care could average more than 77 billion per year.[6]

[7]

Billing Accuracy

The benefits for small to medium private practices that have implemented EMR systems integrated with the practices' billing and prescription systems, can be increased efficiency and accuracy thanks to automatic coding leading to improved profitability. "Since installing the EMR, Medicare has audited only one of my charts. I had billed out as a level four and Medicare said it should have been billed as a level five, which, in essence, said that we should have been paid more. My EMR system gave the chart a level four and I believe it was right.”"Since adopting an EMR system, my practice receipts have increased about $4,000 per month."[8]

Improving Patient Care

EMR Benefits: Healthcare quality

Many EMRs have alert systems that ensure physicians do not forget to request important tests. As well as the legal benefits that this provides, EMR alerts remind physicians of the "preventive care needs for patients, which helps improve quality of care and office income by reminding us to do appropriate testing and provide vaccinations" recommended for some patient conditions e.g. asthma, emphysema or diabetes. [9]

Research

EMR Benefits: Research

Health Information Exchange (HIE)

EMR Benefits: HIE

Personal Health Records

EMR Benefits: PHR

Patient Participation

Patients can use personal health record (PHR) to keep track of information from doctor visits, record health-related information, and link to health-related resources. PHR, is an electronic application used by patients to maintain and manage their own health information. Connected PHRs are linked to a specific health care organization's EMR system that can increase patient and family participation in their own care. [10]

Electronic Dental Records

EMR Benefits: EDR

Telehealth

EMR Benefits: Telehealth

E-Prescribing

EMR Benefits: E-Prescribing

E-Prescribing has many benefits, some of them include: [11]

  • reduce illegibility [12]
  • providing warning and alert systems, which reduce medication errors [12]
  • access to patient's medical history [12]
  • reduces or eliminates phone calls and call-backs to pharmacies [12]
  • eliminates faxes to pharmacies [12]
  • streamlines the refill and authorization processess [12]
  • increases patient compliance [12]

Mobile EMRs

EMR Benefits: mHealth

Physicians

EMR Benefits: Physicians

Physicians Benefit

EMRs can greatly improve communication between physicians by allowing each full access to the patient’s medical record and by making it easier for physicians to follow up with patients. The electronic record provides up to the minute information on the patient allowing more efficient collaboration between disciplines. EMRs allow multiple providers to simultaneously access a patient’s record from any authorized computer.[13]

Nurses

EMR Benefits: Nurses

Costs

Return on investment

It is estimated that purchasing and installing an EMR can cost a provider anywhere from $15,000 to $70,000. There are several things to consider when looking for an EMR for your organization or practice. The prices vary based on number of providers using the EMR and whether it is a select on-site EHR deployment or web-based EHR deployment. Other factors to take into consideration of what costs you will incur include these 5 components of implementation: [14]

  • Hardware: Hardware costs may include database servers, desktop computers, tablets/laptops, printers, and scanners. [5]
  • EHR Software: Potential software costs include an EHR application, interface modules and upgrades to your EHR application. Remember, software costs vary depending on whether you select an on-site EHR deployment or a SaaS EHR deployment. [5]
  • Implementation Assistance: Potential implementation assistance costs include IT contractor, attorney, electrician, and/or consultant support; chart conversion; hardware/network installation; and workflow redesign support. [5]
  • Training: Your organization will need to train your physicians, nurses, and office staff before and during EHR implementation. [5]
  • Ongoing Network Fees and Maintenance: Potential ongoing costs include hardware and software license maintenance agreements, ongoing staff education, telecom fees, and IT support fees. [5]
  • Although the initial cost of an EMR may (and typically does) result in an immediate increase in administrative cost, through the reduction of other “removable and or defunct items or process the implementation of the EMR showed a positive improvement in the BCR and NPV. [15]
   examples: remodeling of paper-chart storage areas, medical transcriptions, shorter chain of communication, reduction of administrative material

==Cost vs Time == (A reduction of time spent on a common process can lead to reduced cost and better efficiency)

  • EMRs can greatly reduce or make more efficient use of time.

A recent study (July-2015)EMR decision support systems where proven to have reduced and or made more efficient use of the time needed for “Colorectal cancer screening where the immediate harms are balanced with longer-term benefits.” By providing a “personalized benefit/harm assessment”. [16]

Implementaion

For a proper return on investment a proper implementation of EHR is needed. lots of things have to be kept in mind for a successful implementation of an EHR.

  • Benefits and risks of the EHR.
  • cost
  • specifications of our needs and what we want and what the EHR have.
  • vendor certifications.
  • preparations for implementation and after.

The journal of Emergency medicine titled with "computers in Emergency medicine" talks about all aspects of EHR implementation. [17]

Benefits Database

EMR Benefits: Benefits Database

Compliance

EMR Benefits: Compliance

References

  1. Centers for Medicare & Medicaid Services. Privacy and Security Standards. http://www.cms.gov/Regulations-and-Guidance/HIPAA-Administrative-Simplification/HIPAAGenInfo/PrivacyandSecurityStandards.html
  2. Turley, M., Porter, C., Garrido, T., Gerwig, K., Young, S., Radler, L., & Shaber, R. (2011). Use of electronic health records can improve the health care industry’s environmental footprint. Health affairs, 30(5), 938-946.
  3. 3.0 3.1 Tierney et al, Medical Education in the Electronic Medical Record (EMR) Era: Benefits, Challenges, and Future Directions http://tmclibrary.summon.serialssolutions.com/search?s.q=tierney+m+j#!/search?ho=t&l=en&q=Medical%20education%20in%20the%20electronic%20medical%20record%20(EMR)%20era:%20Benefits,%20challenges,%20and%20future%20directions.%20Academic%20Medicine
  4. O'Neill, T. (2015, August). Are Electronic Medical Records Worth the Cost of Implementation.
  5. 5.00 5.01 5.02 5.03 5.04 5.05 5.06 5.07 5.08 5.09 5.10 Kumar, S., & Bauer, K. (2011). Medical Practice Efficiencies & Cost Savings.http://www.healthit.gov/providers-professionals/medical-practice-efficiencies-cost-savings
  6. Hillestad, R., Bigelow, J., Bower, A., Girosi, F., Meili, R., Scoville, R., & Taylor, R. (2005). Can Electronic Medical Record Systems Transform Health Care? Potential Health Benefits, Savings, and Costs. Health Affairs, 24(5), 1103-1117.
  7. EMR ROI: A Pennsylvania family practice's investment in an EMR pays off three-fold NP Communications, LLChttp://tmclibrary.summon.serialssolutions.com/search?s.q=tierney+m+j#!/search?ho=t&l=en&q=EMR%20ROI:%20A%20pennsylvania%20family%20practice's%20investment%20in%20an%20EMR%20pays%20off%20three-fold%20NP%20Communications,%20LLC.
  8. How We Improved Our Practice and Our Bottom Line With a New EMR System.Fam Pract Manag, 15(7), 25. http://www.aafp.org/fpm/2008/0700/p25.html
  9. http://www.healthit.gov/providers-professionals/patient-participation
  10. Healthcare IT News http://www.healthcareitnews.com/directory/e-prescribing
  11. 12.0 12.1 12.2 12.3 12.4 12.5 12.6 Healthcare IT News http://www.healthcareitnews.com/directory/e-prescribing
  12. http://www.usfhealthonline.com/resources/healthcare/benefits-of-ehr/#.VfjJDXktDmQ
  13. HealthcareIT.gov http://www.healthit.gov/providers-professionals/faqs/how-much-going-cost-me http://www.healthit.gov/providers-professionals/faqs/how-much-going-cost-me
  14. Removable or Defunct http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3810528/
  15. Cost vs Time http://www.ajmc.com/journals/issue/2015/2015-vol21-n7/Pilot-of-Decision-Support-to-Individualize-Colorectal-Cancer-Screening-Recommendations/
  16. IMPLEMENTING ELECTRONIC HEALTH RECORDS IN THE EMERGENCY DEPARTMENT. http://www.jem-journal.com/article/S0736-4679(08)00321-1.