A Case for EMR Implementation – Multiple Locations

I’ve been discussing the case for EMR implementation recently both on my blog and in emails with various people. In fact, someone even recently commented that the cost of an EMR was less than the EMR stimulus money and so it was a negative return on investment. I quickly responded that maybe he was looking at the wrong EMR companies and also that there were other benefits to implementing an EMR beyond just the EMR Stimulus money.

One example of these benefits is those people who have multiple locations. I was recently talking with someone about how they managed paper charts between multiple offices. What a mess. I’m sure those who read this blog who have done this know about all the challenges. The most important of which is that sometimes you’re left without the chart from the other office when giving care or at a minimum it takes time to get the info from the chart in the other office.

The beauty of an EMR is that as long as you have an internet connection in each location, you can access the full electronic medical record no matter where you see the patient. That’s just one example. Having an EMR solves a number of problems with having multiple locations.

In fact, most EMR are available to you as long as you have an internet connection. Now that mobile broadband internet has become so prevalent, that’s almost anywhere you’d want to access the chart.

Just one more reason to implement an EMR that doesn’t have anything to do with ARRA EMR stimulus money.

About the author

John Lynn

John Lynn

John Lynn is the Founder of the HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.


  • Have you heard about this:
    Regional Extension Centers to Act as Super VAR’s

    · HHS held a call yesterday afternoon giving further details on the roughly 70 regional extension centers (REC’s) to which it expects to grant $643 million. These REC’s are expected to significantly accelerate the adoption of EHR software in primary care physician practices with 10 or less practitioners.

    · REC’s will each select at least two EHR systems, negotiate group pricing and then implement those systems for 100,000 physicians across the county in the next two years. HHS will give each REC roughly $5k per physician it signs up to implement. The REC’s scale, non-profit status and government funding should heavily subsidize implementation costs for participating physician practices.

    · We believe it will be very important for physician practice EHR vendors to pursue these REC opportunities, given that 100,000 physicians could represent roughly half of the incremental EHR adopters in the next two years.

    The Department of Health and Human Services (HHS) held a call yesterday afternoon to go over the details of its $643 million grant program for regional extension centers (REC’s). These REC’s will be non-profit organizations that have a defined geographic area and contract to implement electronic health record (EHR) software for primary care providers (general practice, family practice, internal medicine, pediatrics and OB/GYN’s) in that area. There are expected to be roughly 70 REC’s, which would get about $5k per physician to implement software for 100,000 physicians in the next two years. That number of physicians represents 25-30% of the primary care providers in the country and could be roughly half of the total physicians that incrementally adopt an EHR in the next two years. Each REC will be expected to select at least two EHR software platforms, negotiate group pricing for the physicians in its area, help the physicians select between the EHR options and then facilitate the implementation of that software. The REC’s will also be expected to contract with physician practices to provide them with on-going support and best practices in the use of EHR software.

    The REC’s will only be subsidized by the federal government to help practices with 10 or less primary care providers. Given the limited number of EHR options that will be given to physicians, the focus on small practices and the implementation/support services provided, the REC’s will be similar to the value added resellers (VAR’s) that currently operate on a for-profit basis in many regions of the country. Most VAR’s only push one EHR platform, though.

    There were roughly 1,300 people on the HHS call yesterday, which indicates to us that there will be a lot of non-profit organizations applying to be one of the roughly 70 REC’s. This should give HHS a number of good options, which improves the likelihood that the program is successful. It makes it hard for EHR vendors to determine who the REC’s will be at this point, though. There will be no geographic overlap between the organizations. We believe that each state is likely to get at least one REC, although the organization may not be responsible for the entire state. HHS put an emphasis on REC applicants to not propose a geographic area that would spread their resources too thin. Established health information organizations (commonly referred to as HIE’s or RHIO’s) are the mostly like to be awarded REC grants, in our opinion. Those organizations are already communicating with healthcare providers in their region on the topic of electronically sharing medical records over a common network. The average grant will be roughly $9 million, but it will primarily be dispersed over the next two years as the REC’s sign up practices to implement an EHR.

  • We have a home care practice with 20 users. There are 7 or 8 providers. Basically, they get up in the morning turn on their computer, see the list of the days patients and driving instructions. They see each in the patient’s home and at the end of the day drive home. They only go into the office a few times a month. Complete patient records totally secure and available and they can cover for a collegue at a moments notice with no hassle.

  • Michael Milne,
    That’s what I’m talking about. It changes your office place completely when you think about the mobility an EMR can offer.

  • Just found this site – thanks for information.
    As EMRs move forward – does that include imaging? How is the infrastructure being built regionally that would allow/provide cross continental MR distribution or would EMR’s be just at the regional level with a by-pass/switch in place when needs arise for cross continent transfers?
    Does anyone have a vendor list of providers/implementers?

  • Dfahey,
    There is certainly a fair amount of work going on with imaging, but most of the discussion of EMR hasn’t included much imaging as of yet. They need to get EMRs installed to really make it happen.

    The same goes for MR distribution to an RHIO or other HIE or between the various bodies (cross continent or otherwise). Most of these exchanges are still trying to figure out the policies for exchanging something simple like an allergy or a medication. Until they figure it out, we won’t be seeing any movement in exchanging images.

    Plus, you can imagine the storage needed for exchanging the images. Definitely a huge beast that they’ll tackle one day.

    One clarification is that many EHR companies interface with various imaging solutions. However, those EHR companies aren’t yet interacting with other EHR companies to share the imaging they’ve received.

    I’ve started a wiki dedicated to listing the various EMR software companies: http://emrandhipaa.com/wiki/EMR_and_EHR_Matrix I’m not sure what type of list you’re actually looking for and if it was an EMR list or an imaging list.

  • Imaging is a problem. A study can be several GBs (yes the size of a movie download) so you are talking about moving images the size of movies around, how long does it take you to download a movie? Our Medscribbler Cloud has no problem with serving these up as we host at 7GB burst (1 second for a movie dwonload) But you all know it takes more than 1 sec to download a movie it is the ISP problem. In an office there are 1GB networks now, practically with multiple cards and managed switches you could get up to 1.5GB on a local network. That is only problem number 1.

    Number 2 is if you could actually make the network work work – the monitors to display the image detail are special – the ones at the hospital you see start at $3,000 some in the $20,000 range.

    Number 3 is turf protection by image machine companies like GE and Philips. While dicom was originally suppose to be universal each of these companies has bastardized the format so it is hard for a customer to buy anything other than their stuff (including EMRs)

    Medscribbler is the only EMR I know of that has given any thought to these issues. We use multi-threading to deal with some of the speed issue plus we have an HL7 and dicom interface that will actually deal with about 40 proprietary format issues. The monitor resolution / price issue will not be resolved for years probably. Some small groups or speciality practices may be able to afford them but for now this issue looks like it can only be solved in larger clinics and hospitals.

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