EMRs, Small Business and Universal Coverage

I turned on the radio on Monday and they were talking about Healthcare again. Universal coverage, the August recess, the “blue dog” democrats.

I keep thinking about how EMRs fit into all of this. Obama thinks that EMRs are going to make care better, more efficient and less costly. I think he is right about the first two (if we install EMRs that are usable and bring value to doctors and patients), but not necessarily about the third. EMRs may not reduce costs!

As Obama takes our economy (and our healthcare system) away from the small business model to the big government/big business model, I wonder how EMRs fit into all this. Investing in an EMR is a big deal for most physicians because we are a small business that provides medical care. Spending hundreds of thousands of dollars on an EMR which may not bring return on investment (ROI) while potentially reducing our productivity is a big risk. At the same time, if reimbursement are reduced or the system becomes Universal, the stakes are higher and the risks are greater.

Everyone (individuals and small business) is struggling with our current economy. Small businesses are at risk (many are closing their doors). Physicians are working hard to pay the bills, make payroll and have a little left over to take home to the family. The EMR issue has to be handled correctly or it could have dramatic effects on our healthcare system. The EMRs have to be effective and efficient. Doctors have to like them and be satisfied with their utility and performance. EMRs have to help us take care of patients more effectively and efficiently. Anything less than this throws more sand into the cogs of the healthcare machinery and amplifies the risks of all the other changes occurring at this time.

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Dr. Jeff


  • Estimates are that cost savings from EMRs are at least 8%.
    EMRs don’t cost hundreds of thousands.
    Look for health record banks to give them to docs free.
    Only a tiny minority of EMR converts would consider switching back to paper.

  • Tom,

    There will be no savings if the EMR makes you less productive and the ROI Estimates are just estimates. There may be no return on investment.

    Most EMRs cost over $50,000 per physician. This includes software, hardware, training, support, etc.

    When you get a FREE EMR, you just get the software for free. You still have to pay for the hardware, network, training and support. You may have to pay for additional staff and overtime. You may have to pay for decreased productivity and other costs. FREE EMRs are NOT FREE!

    Only a tiny fraction of EMR converts are very happy with their EMR. Many are luke warm satisfied, many are miserable. Just look at the adoption rate! It is less than 10%! Why? Because most EMRs are not very good!

  • T.J. Rodgers commented on August 2nd, 2009:
    “We are rapidly socializing the United States, where the federal government is controlling more assets in the country than private individuals are. And I think that is a disaster. If you look at any examples of centrally controlled economies, that’s been a disaster. And we’re headed in the wrong direction. With Obama, there is a major sea change of the ownership of assets in the United States of America.” — BusinessWeek, August 10, 2009, page 038. TJ Rogers, President and CEO, Cypress Semiconductor

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