Are electronic medical records right for you?
By Marc H. Sencer, MD

If you are considering purchasing electronic medical records (EMR) software for your practice, be sure you understand the basics before you do. Today’s quiz will help you get the facts.

Which of the following statements about EMRs are true?

A. Before purchasing EMR software, talk to other physicians with practices similar to yours who use the software you are considering for purchase.

B. Insurance companies tend to reimburse better for procedures documented by EMR because the notes are more complete.

C. Because EMRs increase efficiency, your practice will decrease overhead and save money when you switch from paper to EMR.

D. Part of the upside of EMRs is the ease of use —data entry and teaching the staff and doctors to use the system. 

The correct answer is “A,” but “C” may also apply to your practice.

“A” is true. In fact, it is essential you contact other doctors who actually use the system you are thinking about purchasing. EMRs are not cheap, and it does not make sense to make this kind of investment without being absolutely sure the system will function the way you want it to in your practice.

You should also be able to visit other practices and see the system in action.

“B” is not true. It is a common misperception held by many doctors that EMRs automatically produce better reimbursements.

The truth is EMRs that produce the same canned notes for a particular procedure or diagnosis may be construed by third-party payers as canned, and not a true record of the patient’s condition, created by the doctor. There have been cases of reimbursements being cut or denied on this basis.

Be sure the EMR gives you and your providers ample variation to create an accurate record of each patient’s course of treatment in order to receive the best reimbursement.

“C” may or may not be true. This is a trick question because it may be true for some practices, but certainly not for all.

The calculation of return on investment for EMRs works like this: For providers who dictate their notes, it costs, on average, about $6,000 for each full-time physician in a family medical practice to have the notes transcribed.

It then costs another $6,000 to $7,000 for personnel to pull and file paper charts. (These statistics apply to a family practice as statistics are not available for a chiropractic practice.)

So, in theory, you could save $12,000 to $13,000 a year or more for multiple providers. Compare this to the average cost of $10,000 per provider for the system (or $3,000 to $6,000 per year to lease).

However, most chiropractic offices do not transcribe and typically would not have as much chart-pulling and filing as a medical family practice. In addition, EMRs might not save any money for integrated chiropractic practices with part-time MDs — the system could actually end up being an expense!

If you currently use a lot of space for chart storage, you may save money by opening up the storage space for some profit-making activity or to see more patients. Each practice must carefully do these calculations and assess its particular situation.

“D” is definitely false. If you are going to integrate an EMR into your practice, be aware of the steep learning curve involved in teaching the staff to use it. This is not something they will master in one or two weeks.

You should also know it will take hours to input all of the data currently on paper.

Even if you decide not to do old records, you will still have to input basic patient information onto the templates.

The bottom line is that for large integrated practices with multiple providers and/or multiple offices, EMRs may be worth the money, but small solo practices should probably wait. The technology is improving; prices are coming down; and the industry is adopting a form of certification and standardization that until recently had been lacking.

Take your time, do your homework, and carefully asses how an EMR will fit into your current practice in order to reap the benefits.

Marc H. Sencer, MD, is the president and founder of MDs for DCs, which provides intensive one-on-one training, medical staffing, and ongoing practice management support to chiropractic integrated practices. He can be reached at 800-916-1462 or www.mdsfordcs.com.