Tuesday, August 26, 2008

Why a Professional EMR is better

A very smart urologist makes a good argument for a commercial EMR.

In his words:

I commend you for using the home-grown medical documentation system with Word. Advantages of a fully integrated EMR from a "vendor" are numerous. Here are a few: 1. FULL integration instead of piecemeal programs to do multiple tasks. 2. No need to redundantly enter pt demographics / name when you start a new encounter. 3. Electronic charge capture and being able to document within one program and send the charges to the PM side. 4. ONE page summary of just your A&P automatically generated and faxed to PCPs. 5. FULLY INTEGRATED eRx module, instead of having to use a separate system OUTSIDE of the "EMR". 6. Ability to completely mine your EMR database. For instance, I can find all male pts with LUTS over the age of 65 who have not had in-office microwave who also don't have bladder or prostate cancer and who are not on anticoagulants, as well as post an automatic pop up reminder into every one of those pt's electronic charts. 7. Intra-office messaging and integrated patient messaging. 8. Full document management system built-in to handle all incoming and outbound faxes. 9. Auto-documentation of any/all documents generated out of the EMR, including date, time, who generated the doc, and how it was output, including which printer. Accountability and transparency! 10. Requirement to change password according to HIPAA best-practice policies. Word documents are easily hacked. 11. Ability to standardize training and have a program to teach new employees / new hires. I can go on, but you get the idea. To me the price paid for a commercial EMR is completely worth it.

I agree with the above. I do have several caveats.
  • Upfront costs: This is the least of my concerns
  • Ongoing costs: every 6 months the vendors get you for upgrades, maintanenance, etc. All these are very necessary, but you are a captive audience since changing vendors is almost impossible
  • Necessity: do you need all the functionality mentioned. Only you can answer that question. I would suspect that if you have a predominantly insurance based practice in a market place where you can use the data to find leverage, than yes. In my case, with a large cash base and no leverage to negotiate, I am not certain it would help.
But thanks for the back and forth.