Incentive money and EMR systems: is it worth it?

Am I really giving out better care because I use an EMR system? Out of respect for my colleagues on paper charts, I have to say probably not.  In fact, a recent study actually supports this.  Does an EMR allow me to find things faster from my chair and lessen the likelihood of anything getting lost? Absolutely. I read an interesting article in American Medical News the other day on the historic event of the first incentive checks from the government beginning to arrive to what sounds like a very few doctors. In “Meaningful use checks begin to arrive,” we learn of two doctors living and practicing in a family medicine clinic in Durant, Oklahoma who each got $21,250 just now. It turns out that they have a 50% Medicaid population and spent $27,000 on an EMR system five years ago with ongoing maintenance costs of $10,000 annually. So if we do the math — by year five, we’re up to $67,000 — and anticipate that eventually the incentive checks go bye-bye, how is this remotely justifiable from a fiscal perspective? They’re merely stuck paying an ongoing fee and making the EMR company rich.  Now, since I am not paying for my EMR vendor’s product (which I highly recommend if you are okay with that), this is not much of an issue for me.  Nevertheless, I think it’s a bit of a raw deal for those who are paying.  An alternative solution for those paying for EMR systems?  Make sure your break-even analysis is clear and that you are actually not hurting yourself in the long run.  What do you think out there?

Dr. West is an endocrinologist in private practice in Washington, DC. He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC, as a solo practice in 2009.  He can be reached at doctorwestindc@gmail.com.

About the author

Dr. Michael West

Dr. Michael West

Dr. West is an endocrinologist in private practice in Washington, DC. He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC in 2009. He can be contacted at doctorwestindc@gmail.com.

2 Comments

  • Dr. West,

    I’m a long-time HIT analyst, and I’m always intrigued by the arguments for and against EMR systems. (For what it’s worth, unlike most IT people, I’m by no means working from a “HIT is great!” perspective.)

    I’m glad to see some recent discussion reminding people to do a thorough cost-benefit analysis on an EMR. We all seem to forget that MU is optional, and we don’t need to comply with it.

    With that said, a thorough cost-benefit analysis does much more than simply examine the purchase/upgrade costs of an EMR system ($67K in this case) and compare it to net MU dollars. A thorough cost-benefit analysis also must also anticipate changes (for better or worse) in efficiency, patient throughput, documentation errors, reimbursements, etc. Additionally, a cost-benefit analysis must consider that it takes many hours of planning and outside expertise to implement an EMR system that properly fits a practice.

    MU can help offset the costs of an EMR system, but it will, in most cases, not cause an EMR to break even. For some clinicians, staying on paper might be the best way solution.

  • Hi Chuck. I completely agree, not all should convert to an EMR, and you should know what you really want to accomplish in implementing one. You won’t make any money using an EMR, that’s for sure. But I am much more efficient in using one. My life is better than if I were dealing with the problems and inefficiencies of dealing with paper records.

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