If there is one thing that there is no shortage of during
the EHR implementation transition, it is cynicism. Much of this negativity is
certainly warranted when providers are running into legitimate budgetary and
staffing problems, but an even larger portion of the medical community seems to
view speaking skeptically as a personal hobby. Perhaps this devout skepticism
comes from a fear of change, but even more likely is that they think that the
evidence for EHR ROI (return on investment) simply is not there.
Well, we have news for them: EHR ROI is real, and it is not
isolated to just a few anomalies. There have been multiple studies confirming
that some provider organizations benefited greatly from EHR implementation.
While we must acknowledge the real struggles providers are
facing, we must also recognize collectively as a community that negative EHR
implementation outcomes are not inevitable. To stir in this dose of much-needed
positivity, here are a few examples of providers that genuinely saw EHR ROI
within a reasonable time frame:
Hailing from Worcester, Mass. but with facilities throughout
Central Mass., Reliant Medical Group was an early adopter of EHR Software Systems. After
shelling out an astounding $24 million in overall costs, the organization says
that it is already seeing tangible financial and administrative benefits.
Foremost, the more precise coding and documentation
capabilities of EHR are credited with increasing their Medicare Advantage
reimbursements by $2 million annually. They also saw a huge
surge in their compliance rate for Medicare Advantage patients who had chronic
kidney disease diagnoses. Within a three-year period, compliance for these
patients increased from 20 percent to a whopping 80 percent.
Additionally, the time and cost of transcribing dictation
has fallen significantly for Reliant’s centers — a full 63 percent, to be
exact.
Reliant’s Larry Garber even touted that EHRs successfully
made good on their promise to reduce medical mistakes. Looking specifically at
his radiology departments, there was a consistent problem with the wrong tests
being ordered. After customizing a one-click feature that would reveal the
specifics of every test ordered, radiologists could vet the pending test
requests and confirm or correct them before they were scheduled.
In total, the percentage of radiology tests requiring
expensive ordering changes post-scheduling declined from 12 percent to four
percent. This reduction saved both patients and providers resources, especially
the radiologists who had more time to perform tests that were genuinely needed.
Small Practice EHR
Wins
While not every provider has the budget to lay down a cool
$24 mil on the table for EHR, many smaller pilot clinics were still able to
budget for their EHR implementation properly and see some EHR ROI within a few
years.
Here are some five-year case studies courtesy of Providers Edge:
●
OB/GYN of West Michigan saw a 65 percent return on
investment after cutting six full-time-equivalent staff positions in
transcription and nursing as a result of increased efficiency.
●
Nash OB-GYN Associates, hailing from Rocky Mount, North
Carolina, saw a huge 71 percent reduction in both transcription and supplies
costs.
●
Lakewood Family Medicine of Holland, Michigan enjoyed a
50 percent EHR ROI, with savings of $100,000 per year on reduced transcription
costs alone. Administrator Beth Zandra even fully-endorsed the decision, saying
that, “There’s no way my physicians would go back to paper medical records.”
●
One Dr. Jack Dekkinga had an unusually-glowing case for
EHR ROI. While his costs for transcriptions and supplies fell just like the
other study participants, his receipts also grew by 32 percent coupled with an
18 percent increase in total patient encounters. His small practice was able to
achieve an astounding 240 percent ROI, allowing him to pay for the costs of his
EHR system in just over five months.
Getting Realistic
About EHR ROI
Not every provider organization will see the storybook gains
described above, but they will also likely not endure the catastrophic losses
bandied about by devout naysayers. The real point is to illustrate that losses
are not inevitable.
In fact,
one of the most comprehensive studies on the
subject of EHR implementation found that small practices would recoup their
losses after two and a half years, on average. After that, they could expect
incremental gains in the years to come. While this timeline may seem drawn out
for some, providers must come to grips that the expectations of EHR
implementation are coupled to the promise of better efficiency and better
patient care. Tangible, cash results thus may pale in comparison to the
revitalized landscape that EHR promises in the long run.
If such idealism is not enough to float your boat, at least
take comfort in the fact that significant Medicaid incentives can be had if you
implement EHR sometime next year. Between incentive programs like these and the
potential gains evangelized by those above, now is the time to create a serious
EHR implementation strategy and adjust to what will inevitably color the future
of modern medicine.
