Thursday, June 21, 2007

Is There a Business Case for Electronic Health Records?

If you're a physician, you've surely heard promises of greater efficiency and improved patient outcomes associated with electronic health records (also called electronic medical records, or EMRs), but do these medical software programs yield a business payoff for small physician offices?

Yes, according to Stefanos Zenios, Ph.D., a healthcare IT expert and professor of operations, information and technology at California's Stanford University.

"There is a perception that there's no business case for adopting electronic health records in small or midsize groups," Dr. Zenios said at a recent health care congress sponsored by the Wall Street Journal and CNBC. "That's not the case if one considers the economic data carefully."

Dr. Zenios cites a fourth-year return on investment of 31% due to improved billing and patient follow-up, noting that "not even the venture capitalists can see returns as high" as 31%.

Better data mining is another way that practices can increase practice revenue. In one example cited by Dr. Zenios, a 26-member cardiology group in North Carolina used EHR/EMR data to look for patients at risk of sudden coronary death, and found nearly 300 primary prevention candidates and more than 1,400 patients who were candidates for secondary prevention. The data search translated into more than 1,300 new consultations, 900 echocardiograms, 500 T-wave tests and 500 implantable cardioverter defribrillator implantations. (Not to mention $2.8 million in additional practice revenue.)

The quality of patient care also improved. Those additional consultations and tests had the clinical impact of averting 37 sudden cardiac deaths each year.

Of course, installing an EMR medical software system is not without its risks, and Dr. Zenios is careful to remind physicians to do their homework before selecting an EMR system. He offers several suggestions to help physicians better manage the risks involved:

Expect some initial redundancy with your new EHR/EMR system. "People put a new information technology system in place, and the next morning they turn off their previous system. It doesn't make sense. It's costly to have both systems in place, but that protects you. For 3-6 months, there has to be some redundancy."

Assess the system's ability to improve your medical billing process. For example, the system may be able to flag procedures for which physicians are routinely underbilled and bill them at the proper level.

Assess the system's capability to take advantage of all the data that will become available. "Some innovative practices are using this capability to deliver better quality of care to their patients and improve their revenue."


Christian Sinclair, MD said...

Do you have any experience in hospice based EMR's? Any comments on how EMR's are flexible or inflexible given the wide variety of practices?

Good start to your blog too. Looks like some interesting stuff.


ryanbyrd said...

Isn't it funny that we're even asking this question? For every other domain, it's simply taken as a given that information technology streamlines processes and provides much needed feedback metrics for improvement (you can't improve what you can't measure, after all! )