PHILADELPHIA — Electronic health records improve patient care, streamline record keeping, and substantially boost practice efficiency, agreed three rheumatologists who have switched from paper to electrons.
“I have gone from seeing 25 patients a day [before switching to electronic health records] to seeing 40 patients a day,” Dr. Charles King commented during an electronic health record forum at the annual meeting of the American College of Rheumatology.
Other benefits from adopting electronic health records (EHRs) are that “our data are clearly better, our work flow is certainly better, we have improved communication within our system, and we can more easily do research,” added Dr. King, senior rheumatologist at North Mississippi Medical Clinics in Tupelo.
Dr. King chairs the ACR's Committee on Rheumatologic Care's health information technology subcommittee, and organized the forum.
But physicians must realize that starting up an EHR system also has significant disadvantages: an expensive up front cost, a large learning curve, loss of face time with patients, and privacy issues that the system must be designed to address.
Data entry during the physical examination is the most challenging part of EHR” record keeping, and as a result he still handles that aspect by dictation.
Dr. King also warned that entering impressions and management plans into a patient's record can end up as simply a list rather than more insightful thoughts.
“We cannot lose the thinking style of rheumatology” when using EHR, he warned.
Start-up problems can be so daunting that Dr. King, as well as his colleagues at the forum, recommended that practices build their EHRs in stages.
Another speaker at the forum, Dr. Craig Carson, documented the improved efficiency that came with the introduction of EHR into his practice at the Oklahoma Arthritis Center in Edmond.
During the third year that his three-physician practice had an EHR system in place, they had a $123,000 boost to their income, the result of being able to nearly double the number of patients seen per day.
Dr. Carson reported going from an average of 18 patients per day to 28, and his partners had even more expansion. But this benefit was balanced by a first-year start-up cost of more than $257,000.
“The cost is considerable, but it leads to rewards,” said Dr. Carson, who also serves on the ACR's health information technology subcommittee.
The start up was also an ordeal. “You need someone [in the practice] who decides that 'no matter what, we'll stick with [EHR]' because it is not easy. You'll have employees who say they can't do it and want to quit. You need to get through that. Once you do, everyone will be happy,” Dr. Carson said.
Another subcommittee member who spoke, Dr. Thomas Geppert, had his own list of benefits that have come from adopting EHRs.
They included improved quality of care because of better access to patient data, availability of computerized prescribing, an easy system for generating reminders, the potential to incorporate rules that minimize mistakes, and easy access to patient records from anywhere.
Other benefits have been better work flow organization, a need for less office staff, and improved communication with patients.
Like his colleagues, Dr. Geppert, a physician at Rheumatology Associates in Dallas and another member of the ACR's subcommittee dealing with health information technology, also cited the disadvantages of cost, the potential for system failure, and the ordeal of getting a system in place, and recommended introducing a new EHR system in stages.
Disclosures: Dr. King, Dr. Carson, and Dr. Geppert all said that they had no financial relationships to disclose.
'I have gone from seeing 25 patients a day [before switching to electronic health records] to seeing 40' a day.
Source DR. KING