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

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'''EMRs can have a significant effect on patient care when successfully integrated with a fully featured Laboratory Information System (LIS) including:'''
 
'''EMRs can have a significant effect on patient care when successfully integrated with a fully featured Laboratory Information System (LIS) including:'''
  
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*Decrease in patient stays - a delay of a few hours through inefficient ordering processes can increase length-of-stay by up to 24 hours for some tests
 
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*Results in fewer diagnostic duplications, especially when coupled with a CDSS (which otherwise must be monitored by specially trained nursing or lab personnel
 
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*Can greatly reduce patient morbidity and mortality (once again especially when coupled with a CDSS) by quick reporting of critical values directly to involved providers.
 
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* Share integrated information - with better information integration capability, you can facilitate better quality care, contain costs, and better manage risks. MsdC's integrated solutions enable these clinical and business advantages by creating a clinical healthcare system that unites the crucial patient information with the varied departments. This creates a central clinical information repository and resource used throughout your integrated delivery network.[http://www.msdc.com/EMR_Benefits.htm]
 
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* Provide rapid access to comprehensive information when needed - fewer misplaced or duplicate charts[http://www.msdc.com/EMR_Benefits.htm]
 
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* Adapt to regulatory changes - Meet HIPAA and other legislative and regulatory challenges with organized, complete information.  Our clinical information systems allow administrators and management to more easily document and conform to the changes in the regulatory environment. These systems allow auditors and regulators to rapidly assess compliance.[http://www.msdc.com/EMR_Benefits.htm]
 
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* Share integrated information - With better information integration capability, you can facilitate better quality care, contain costs, and better manage risks. MsdC's integrated solutions enable these clinical and business advantages by creating a clinical healthcare system that unites the crucial patient information with the varied departments. This creates a central clinical information repository and resource used throughout your integrated delivery network.[http://www.msdc.com/EMR_Benefits.htm]
 
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* Compared to paper records, utilizing an Electronic Medical Record (EMR) system is a rapid and efficient method to preserve critical medical information.[http://www.msdc.com/EMR_Benefits.htm]
 
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* Better manage risk and lower cost - By consolidating information across your clinical operations, from admission to treatment to labs and beyond, you increase the pace of information flow including service delivery, coding/billing accuracy, and better document patient encounters and work — all while reducing your operating costs. Further, EMR systems provide for more consistent application of medicine protocols. The rapid availability of information 24x7 contributes significantly to better decision making, reduced errors, improved outcomes, and lower malpractice risk.[http://www.msdc.com/EMR_Benefits.htm]
 
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* LTAC facility employees who work with EHR systems on a daily basis were positive about their experiences. In particular, operational improvements were achieved through increased access to resident information, cost avoidance, increased documentation accuracy, and implementation of evidence-based practices.
 
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Health_Care_Manage_Rev. 2011 Jul-Sep;36(3):264-74.
 
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* EHR-based, triggered ADE reporting is efficient and acceptable to clinicians, provides detailed clinical information, and has the potential to greatly increase the number and quality of spontaneous reports submitted to the FDA. Pharmacoepidemiol Drug Saf. 2010 Dec;19(12):1211-5
 
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* A study performed by Rosen et al. (2011) showed that transitioning a rheumatology practice for children to an EMR resulted in an increase in family satisfaction with an office visit. Kudler, N.R., Pantanowitz, L. (2010). Overview of laboratory data tools available in a single electronic medical record. J Pathol Inform, 3.
 
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* In 2011, Furukawa concluded that EMRs “may improve provider productivity, especially during visits for a new problem and routine chronic care”. Furukawa, M.F., (2011). Electronic medical records and efficiency and productivity during office visits. Am J Manag Care, 17, 296-303.
 
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* According to Kudler and Pantanowitz (2010), there are many advantages to having flexible electronic laboratory data in an EMR.  For example, laboratory data can be viewed, sorted and pooled to support and determine trend analyses, used for clinical decision making and charting (3).  In addition, flexible laboratory data in an EMR has that capacity to help further the development of better clinical decision support tools (Kudler & Pantanowitz, 2010). Rosen, P., Spalding, S.J., Hannon, M.J., Boudreau, R.M., Kwoh, C.K. (2011). Parent satisfaction with the electronic medical record in an academic pediatric rheumatology practice. Journal of Medical Internet Research, 13, 40.
 
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* Electronic Medical Records (EMR) are beneficial to all parties involved in the managing, receiving and the financial aspect of healthcare which includes the healthcare facility, the patient and the payor of services  1. Reduced offline and in house storage cost of paper based records. Paper records for legal reasons must be kept for several years. When records are not accessed for a certain period of time, they are taken off line and warehoused. Storage of these records is very expensive and time consuming when having to retrieve the document for use. 2. Enhanced Patient care. Patient care improves by having their health information readily available to their clinician for viewing and updating. By having the medical records available to the clinician, the patient can receive timely diagnosis and treatment in addition to reduced healthcare cost from additional test and procedures. 3. Payors such as insurance companies and the government will save from eliminating the cost for additional procedures and possible hospital stay for patients due to lack of correct diagnosis from limited information.
 
  
 
[[EMR Cost Categories]]
 
[[EMR Cost Categories]]

Revision as of 19:23, 12 September 2011

EMRs have many benefits and return on investments

Benefits

-  Major Healthcare savings - Savings in terms of duplication of services. Records and diagnostics tests can be easily shared among various providers. 
- Reduced Medical errors - There will be reduction in medication error and adverse drug event rate
- Improved care - Better disease prevention and Chronic disease management.

Richard Hillestad, James Bigelow, etal. Can Electronic Medical Record Systems Transform Health Care? Potential Health Benefits, Savings, And Costs. Economics Of Health Information Technology Health Affairs, 24, no. 5 (2005): 1103-1117 doi: 10.1377/hlthaff.24.5.1103


Investment Flexibility:

How much investment is available over a certain period of time? For example if a hospital considering to install a nursing system may conduct a pre- and post-implementation analysis of investment including maintenance cost, operating cost, nursing time and activities, determining the exact time spent on each patient activity.

Management Risk Disposition:

Willingness to invest in experimental efforts.

Provide users with real time knowledge

Reducing non-clinical time

Increase patient doctor time:

Investment Motivation:

To reduce cost, position for capitation/managed care, and gain market share.

--Sfjafari 22:21, 10 September 2011 (CDT)

--Sfjafari 22:29, 10 September 2011 (CDT)

Administrative and management benefits: 

- Overall transparency among the processes
- Improved communication among the clinical to clinical and clinical to administrative staff
- Less errors will reduce the no. of malpractice litigation 
- Reduced reimbursement time & less questionable claims
- Performance would be easier to maintain
- Reduction in hospital lengths-of-stay
- Reduction in nurses' administrative time
- Reduction in drug and radiology usage in the outpatient setting

Return on Investment

Quantitative Benefits:

These are financial benefits that are clearly measurable and are attributable to the use of a particular technology. E.g., the use of EMR technology to submit claims has resulted in widely quantified cost savings for provider and payer organizations.

Qualitative Benefits: 

The EMR will improve patient care by reducing medication error and wait time. Clinical processes will be standardized and there will be less variation in clinical care provided at place from another. Records would be easily shared among the providers, which will reduce the process time and over all improve the disease management.It will also improve the communication among the care providers and the administrative staff and administrative activities.

These are directly and indirectly attributed to the technology but are more difficult to quantify. E.g., implementation of a clinical nursing system may lead to increased case in recruiting efforts, better nurse retention, more rapid access to clinical nursing data, and decreased charting time. Quantification and measurement – of benefits usually is difficult because of the task complexity of the nursing function.

Strategic Benefits:

These offer substantial benefits to the organization, but at some future date. E.g., investments in networking and telecommunications offer significant future strategic benefits, positioning organizations to utilize enterprise-wide patient indexing and EMR or distributed case management technologies as they emerge.

--Sfjafari 22:29, 10 September 2011 (CDT)


Emr systems with business intelligence functionality can measure organizational performance with the IT investment. This capability shows relationship with organizational metrics and the cost savings of the IT investment. --Zoker

Costs

The Medical Group Management Association (MGMA) says the average cost of an EMR per physician is $33,000. (http://www.physicianspractice.com/display/article/1462168/1591117)

Software License:: EMR license prices can easily range from $1,000 – $25,000. The average license for a FULL/TRUE EMR usually starts at $10,000, while a light/entry EMR usually starts at around $1,000, and these costs tend to recur. (http://www.phyaura.com/resources-2/open_source/)

Implementation: Implementation costs are usually billed hourly at a rate of $75-$150 per hour. Average implementation time per provider is 35 hours. Where 10 hours are used for customization, 25 hours for training and 10 hours for computer/network setup. This becomes exponentially lower as more physicians are added. (http://www.emrexperts.com/emr-roi/index.php)

Hardware: Network hardware and configuration, number and type of servers/workstations, hand-held devices, etc. is driven by the vendor's requirements and recommendations, as well as your organization's needs. Costs depend on quantity of equipment purchased or leased. For example, a tablet PC could cost $2,000, a workstation $1,500 and a server $5,000. (http://www.emrapproved.com/emr-hardware.php)

Support & Maintenance: Ongoing support costs will be incurred from both an annual support contract with the software vendor for updates and technical support and the increased need of hardware/network support through a local IT representative. (http://www.emrexperts.com/emr-roi/index.php)

Research

Barriers of EMR Implementation

  • In order for an EMR to be truly successful, proper and timely training must be administered to all who will interact with the system.
  • Conflicting research findings on the cost and efficiency benefits of EMR implementations will make it difficult, if not impossible, for administration staff to be confident in choosing an EMR for their facility. Until there is adequate research on multitudes of EMR systems that shows causal relationships between facility characteristics and the related EMR components there will not be a sufficient method of EMR selection and implantation.
  • If it is true that implementations of EMRs cause a decrease in efficiency and an increase in quality of medical care then further research must take both of these repercussions into account and determine if there is an overall net benefit of EMR implementation.
  • The variability of results of similar studies on the monetary and efficiency benefits of EHRs indicates that there is no single approach to EMR implementation that will fit all settings. Variables such as hospital size, setting, specialty, prior computer integration, etc will determine the effectiveness of an EMR dramatically and must be considered in all cases.

Communication

EMR's will enable health care personnel and patients to communicate and exchange data better and in a more accurate and efficient way.

Physician-Physician

  • Access to past records
  • Transitioning care
  • Collaboration in patient care (consultation)

Physician-Patient

  • Best practice guidelines
  • Directed advice
  • Continuity of care
  • Telemedicine

Better data quality and legibility due to:

  • aggregation of data
  • warnings of invalidated data
  • EMR data more legibile than handwritten data

Humpage, Sarah D., "Benefits and Costs of Electronic Medical Records: The Experience of Mexico’s Social Security Institute." Inter-American Development Bank. June 2010. www.iadb.org/document.cfm?id=35219845

Clinical

  • EMRs can help eliminate false negatives by comparing previous and current test results. In a 2003 study, Kleit and Ruiz demonstrated that implementing an EMR reduced the number of false positives mammograms by over 50 percent by making previous mammograms available to clinicians at the time of diagnosis. Previous mammograms did not affect the number of false negatives. Kleit, N. A., Ruiz, J. F. 2003. False Positive Mammograms and Detection Controlled Estimation. Health Services Research, 38(4), 1207-1228.
  • EMR software is packed with many tools to help doctors make better decisions. These tools range from diagnosis to prescribing medications to treatment plan recommendations. Most EMR's have built in PDR-based medication dictionaries providing doctors with Adverse Drug Event (ADE) alerts, generic drug and dosage recommendations.(http://www.emrexperts.com/why-emr.php)
  • In one EMR pilot project to implement EHR in a developing nation (Cameroon), one of the significant benefit was increase in best practices. Boren, Suzanne and Williams, Faustine."The role of the electronic medical record (EMR) in care delivery development in developing countries: a systematic review." Informatics in Primary Care 2008;16:143.

Operational

  • EMR allows researchers to efficiently search patient medical information by medical condition, date of treatment, physician name and test category. Researchers can more quickly focus their attention on medical information that supports their research efforts, develop databases to study patient outcomes, and cross-check complex medical information.(http://www.mayoclinic.org/emr/benefits.html)
  • EMR can increase the revenue by giving the ability to offer new services to patients. Many EMR vendors offer features for patients to view their medical information, schedule/cancel appointments and complete forms ahead of time via the organization’s website. This can help attract new business and reduce the load on the staff.(http://www.emrexperts.com/why-emr.php)
  • EMR enables generation of report easily and instantly. Reports can be conveniently generated and programmed to automatic settings. Such reports can be used for assessment of various variables of performance, analysis, compliance and for research studies.
  • Regionally integrated EMRs can help improve the safety of ar-risk patients, or narcotic addicted patients who may visit several emergency departments seeking treatment and medications for their habit. This can save time and cost since these patients may not have health insurance, and time that would have been spent on these patients can be extended to the care of emergency patients.
  • By combining clinical data from EHR with data from other sources such as OTC purchase, school absenteeism rate, it can be used for better monitor of disease outbreaks. Ref: Nir Menachemi, Taleah H Collum. Benefits and drawbacks of electronic health

record systems. Risk Management and Healthcare Policy 2011:4 47–55

EMRs can have a significant effect on patient care when successfully integrated with a fully featured Laboratory Information System (LIS) including:


EMR Cost Categories

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