Once physicians go electronic, they discover many benefits, said Charles Parker, vice president and chief technology officer for Masspro, a health care performance improvement organization founded by the Massachusetts Medical Society. “In 99% of clinics, you can see return on investment in EHR within 2 years. And in some best cases, you see ROI in 90 days.”
In studying physician practices in Massachusetts, he said the big savings come from reduced need for transcription services, fewer redundant lab tests, swifter claims processing, and fewer days for claims in accounts receivable. He also noted that Medicare and Medicaid in his state include financial incentives for physicians to comply with formulary guidelines, and this is far easier to do and to document in an EHR-based office.
Doctors using EHRs also spend, on average, less time on the phone with patients, and staffers spend markedly less time tracking down lost records or missing bits of information. “All the information is always at everyones' fingertips,” Mr. Parker said.
Participation in pay-for-performance plans also requires digitized information, and some of these plans will help foot the bill for physicians to implement EHRs.
Mr. Parker, and many other EHR advocates, believe EHRs will increasingly become a central feature in the “medical home” construct, which is now a very hot idea among health plan administrators and big employers.
He noted that the National Business Coalition on Health's widely touted Bridges to Excellence program will be preferentially rewarding clinics that meet their definition of a medical home. Electronic capabilities are part of those criteria. He said that he believes that incentive structure may very well be the strongest incentive to move primary care physicians to embrace EHRs, and he called on vendors to pay more attention to this feature.
“You need to enable doctors to get the medical home assignation at the end of the process. You need to enable them to realize real revenue increases as a result, or there's simply no incentive. EHR companies are usually only focused on selling EHRs, but they fail to attend to the full-blown aspects of practice assessment and care redesign,” he said. “EHRs are really a tool for practice redesign. You really can improve the efficiency of care.”