Less than 20 percent of doctors currently use electronic medical records.
One of the more cited reasons is that, in a fee-for-service payment system, doctors often lose money since the number of patients they see decreases during the long implementation phase.
Paying doctors by the hour will solve that problem. Consider this physician, who said “he had to give up his solo practice after he had invested $38,000 in software for systems that kept crashing and thwarting his attempts to send out electronic bills.”
Having to play his own IT consultant fixing the system often drew his time away from patients, and he couldn’t keep his practice financially solvent.
After moving to a new job that pays by the hour, he doesn’t worry if the software crashes.
If doctors were relieved of the financial pressure of seeing more patients, and paid on an hourly wage, I suspect that many more would be willing to take the time to go digital.
Related posts:
- How the widespread adoption of electronic medical records can raise health care costs
- Do electronic medical records increase physician communication of critical test results to patients?
- Op-ed: Why doctors still balk at electronic medical records
- The low adoption rate of electronic records
- How electronic medical records can lead to coding fraud, and get doctors into major trouble
- The slow adoption of electronic records
- Can Wal-Mart help doctors implement electronic medical records?
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if you pay by the hour, they will say you still have to see a certain number of patients a day so it won’t make any difference.
The 20% population seems quite low. Is this 20% based on the USA, North America, or Worldwide?
Just as a devil’s advocate here, couldn’t insurance say they already pay for some procedures by the hour? I know there are some things that are done in our office that are billable in 15-minute increments.
To the real point, my feeling is that any time you can provide a doctor security/peace of mind, the quality of patient care will rise. Whether he or she is seeing five or fifty patients in a day, one less worry is one more focused thought on the person needing treatment.
Pay based on performance will always be more efficient than pay based on time for the simple reason that the incentives are immediate and positive. Bundling the time it takes to keep bad tools working, such as IT systems, will quickly price the service out of the marketplace.
Chuck Brooks
FutureWare SCG
The problem, obviously, is the EMR companies that charge fees for software and support that would make Bill Gates blush with confiscatory embarrassment.
I’m not saying that companies like NextGen don’t make a good product… but hundreds of thousands of dollars to set up and run a large system (and several thousands for basic service) in a business of shrinking margins is impractical if the learning curve is anything but a bunny slope.
I know practices that have 15 year old software that actually does what it was designed to do and it has paid for itself 1000x over, but again, its the empty promise of seamless integration with billing, records and office productivity that leaves older docs cold.
There is no robot or program that will “just make it work” … you have to do that yourself… often at much greater cost (in time and money) than you thought.
I think the future is modular, upgradeable units from different vendors… in other words… get the product or service that does WHAT YOU WANT as a doctor and don’t use OR PAY FOR what you don’t use.
Unless you are a hospital with in-house IT, all in one solutions, so far, are just cash sink-holes if you ask me.
Switching to electronic records is a business process. Clearly some Docs aren’t capable of managing it.
It will separate those who aren’t able businessmen from those who are.
The former need to be on a salary without someone else running the business. The later can manage both aspects.
Sounds great so those of us that are computer savvy and efficient will get to sit around and talk about the weather, the boys football team or day trade for 4-5 hours every day.
>>"Switching to electronic records is a business process. Clearly some Docs aren't capable of managing it.
It will separate those who aren't able businessmen from those who are. . . . . . .
>>>>
And it will separate those who actually know what they are talking about from the blowhards that don't.
Obviously that was written by someone who has never actually done the conversion to an EMR, or by someone who has been responsible for clinical operations while that process was conducted.
When you decide to become less of an asshat, perhaps you will appreciate the difficulty that implementing these programs brings to a busy clinical environment that has goals like, say, paying its bills.
Unless you are in a habit of losing lots of charts, or you need to service a large population of patients in several locations at once, or you represent a multi-physician clinic where patients are seen by several physicians in short order and where diagnostic studies are done and recorded in house, or you can't code your work well, the benefits of EMR are questionable. For a one or two doctor practice in a single location, they are especially questionable, and that represents a substantial chunk of the private practice market.
Most practices can't afford an IT contractor and definitely can't afford an IT staff, and some of the programs require extensive ongoing support to keep them running well.
You really don't make that back in efficiencies in a small practice setting. And let's not even go to matters like upgrades, machine interfaces, new employee training costs and additional hardware costs.
"Need to become employees." What an arrogant fool.
>>"Switching to electronic records is a business process. Clearly some Docs aren't capable of managing it.
It will separate those who aren't able businessmen from those who are. . . . . . .
>>>>
And it will separate those who actually know what they are talking about from the blowhards that don't.
Obviously that was written by someone who has never actually done the conversion to an EMR, or by someone who has been responsible for clinical operations while that process was conducted.
When you decide to become less of an asshat, perhaps you will appreciate the difficulty that implementing these programs brings to a busy clinical environment that has goals like, say, paying its bills.
Unless you are in a habit of losing lots of charts, or you need to service a large population of patients in several locations at once, or you represent a multi-physician clinic where patients are seen by several physicians in short order and where diagnostic studies are done and recorded in house, or you can't code your work well, the benefits of EMR are questionable. For a one or two doctor practice in a single location, they are especially questionable, and that represents a substantial chunk of the private practice market.
Most practices can't afford an IT contractor and definitely can't afford an IT staff, and some of the programs require extensive ongoing support to keep them running well.
You really don't make that back in efficiencies in a small practice setting. And let's not even go to matters like upgrades, machine interfaces, new employee training costs and additional hardware costs.
"Need to become employees." What an arrogant fool.
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