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Physicians Practice. Vol. 17 No. 13
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Technology Survey: The Good, The Bad, and The Very Ugly

Physicians wrestle, sometimes successfully, with EMRs, other tech offerings

By Mark R. Cheshire | September 1, 2007


For those of you struggling to convince your partners to plunk down the cash for an EMR, to find the right system for your practice, or to get the darn thing you already bought to work, our survey should give you reason for optimism. Of those who have successfully taken the entire plunge, buying and implementing an EMR, an overwhelming 81 percent say it has made work flow more efficient. Just 6 percent say it has made them less efficient. Moreover, 61 percent of EMR owners were able to reduce or reassign staff. In other words, many are operating more efficiently with less staff — a disagreeable development for some employees, to be sure, but highly desirable for employers.

EMR Effieciency

And while many struggle to fully implement EMR systems (26 percent), 52 percent did so in a mere month. An additional 22 percent wrapped up work in three to six months. At About Women Ob-Gyn in Woodbridge, Va., the keys to a successful implementation were timing, preparation, and strategy, says Yolanda Raffert, the practice’s administrator.
For example, About Women transitioned from paper to an EMR in stages.

The challenges now, she says, are “managing physician time to include routine training … and to keep up to date with changes and enhancements. … Everyone was very interested in the initial roll-out; however, it is challenging to keep their interest in its growth and development.”

EMR Implementation

While no implementation is effortless, scores of practices out there are worthy of emulation.

“We incorporated an EMR and practice management [software] into our practice over the last four years,” says Dan Berg, a family practitioner with Parkview Medical Clinic in New Prague, Minn. “We keep our servers on site. We are independent, and we’re making a go of it!”

Show me the price tag

OK, but what about cost?

Nearly half of respondents (48 percent) say they paid less than $500 per physician for the necessary software (hardware excluded). Not bad. You can easily spend more on a dinner for four at some restaurant named for the chef.

But here’s where it gets weird: Twenty-three percent say they spent more than $6,000 per doc. Rather provocatively, there’s not very much in between the lowest and highest price points. No $1,000 increment between $500 and $6,000 got more than 5 percent. By the way, these results are completely consistent with those of our previous tech surveys.

There are myriad explanations for the enormous disparity. Just as there are Geo Metros and Ferrari Spiders, there are economy and luxury models. Different approaches to the technology also affect pricing. Vendors can offer this stuff via a Web site, or they can come to your site and load it all onto your server.

Software

The gargantuan price differential also results in part from industry fragmentation and product diversity, explains Nancy R. Smits, a healthcare industry consultant and president of SHR Associates in Annapolis, Md. When consolidation and standardization come about, as they inevitably will, product pricing will smooth out, she predicts. One day, EMR software may even approach commodity status, which will be good for you, perhaps less so for vendors.

Regardless, you’ll be well served by some hard-core competitive shopping. Those in the market clearly understand this. Fifty-eight percent of survey respondents say it took them (or most likely will take them) as much as three months to select an EMR. The other 42 percent expect to look around for four months to a year, maybe longer.

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