Happy EMR Doctor’s Note: Ken Harrington, PhD, is my practice manager and he accompanied me recently to the Practice Fusion Connect 2011 users conference on 11.11.11. Here are his thoughts on doctors’ offices that have made the switch to a digital work environment and the HR differences it will inherently bring.
I recently attended the Practice Fusion users conference Connect 2011 where I viewed a lecture on the evolution of the doctor’s office with the arrival of electronic medical record software systems. Many blogs and articles have already been written on (1) how EMRs are saving space in the doctor’s office with the elimination of the paper charts and (2) the saving of dollars with the elimination of staff to file and manage the paper charts. However, I am finding in the office where I work that EMRs are also changing the HR aspect of the doctor’s office.
I am the Practice Manager responsible for coordinating hiring all new employees at The Washington Endocrine Clinic in Washington, DC. When the office opened a little less than two years ago, there was no shortage of area doctors who wanted to offer their advice to Dr. West on how best to run the office and meet staffing needs. One of these suggestions was to keep costs down by not paying more than a minimal hourly wage for front desk staff. Being a novice at running a doctor’s office, I followed this suggestion and employed people in this low price range. What I found was that this salary range usually resulted in staff that had not completed a college-level education, had little experience in using the technology involved with an EMR, and seemed to have little motivation to push the envelope in terms of learning new skills.
Now I should mention that when this doctor’s office was set up, it was designed to be as paperless as possible. This meant that there would be no paper charts in the office, and every document related to a patient was stored in the EMR. A website was developed where new patients were directed for registering and reviewing the policies of the clinic. A high-speed scanner was installed to convert to a PDF form all documents that patients brought into the clinic, and an electronic fax was set up to convert all incoming documents to PDF files. All of this required staff who were familiar with working with such technology. We thought it would be simple enough to teach anyone how to use all of this equipment and software, but this was not exactly the case. We discovered that, while intellectual curiosity was a key human element required for excelling in this new world, such a characteristic was not present in our earlier workers. Indeed, I remember it taking all day for these employees to complete tasks that are now completed in around 30-60 minutes by our newer staff.
We went through several employees before we finally decided that we would hire future employees with the minimum of a college bachelor’s degree and pay them a higher wage. What we found in doing this was a different type of employee. The employees we have in the office now are skilled enough with technology and time management skills from their college and corporate work experience to perform efficiently. The employees who are paid a higher salary bring to the office better customer service abilities, more intellectual curiosity, better problem solving skills, and team playership skills. As much as we liked saving money on previous employees, the skill set bought with such money was simply insufficient for a technology-centered doctor’s office.
Now some critics will say that, in the end, I did not end up saving money with the adoption of an EMR because I paid higher salaries. I do not agree with this thought. The higher motivation among our current employees, we estimate, has actually been able to cut our staffing needs by an additional full-time person.
Other critics might say that the adoption of an EMR has created such a highly technical office that it will become too technical to manage. Again, I do not agree. Our employees are so comfortable around the technology that they can usually figure out the answers to challenges that arise. They know how to clear a print spool when the printer hangs up. They know how to use a PDF converter program to sign a document or fill out a form without having to actually print it. They know how to walk a patient through filling out and e-mailing the online registration form when patients encounter difficulty.
EMRs are changing not just the physical appearance of doctors’ offices, but also are changing the culture of the office through raising the bar for qualifications of people hired to run and manage the office. It is not that employees paid lower salaries cannot learn these new techniques. My point is that hiring employees who are more educated and skilled with using technology allows for a smoother transition into a paperless and technology-centered office. This fundamental change in HR will reshape the ethos of future physician offices.
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 and opened The Washington Endocrine Clinic, PLLC, as a solo practice in 2009. He can be reached at email@example.com. He blogs at HappyEMRDoctor.com and EHROutlook.com.