Can An EMR Focus on Patient Care in the Current Reimbursement Environment?

In response to a discussion I was part of on LinkedIn, Hirdey Bhathal, CEO of Zibdy Health, offered these interesting comments:

In your comment above you say “Doctor’s are eager to improve revenue”, “clinically based reimbursement” and “emphasizing the clinical documentation that needs to be the base line for billing”….Given that how can a EMR even try to focus on patient care? Two workflows are very different and probably mutually exclusive or very difficult to bring together with any degree of success. In a situation like that a new vendor like practice fusion or any other will be forced to comply with revenue needs otherwise no provider will adopt them. This is the first feature any EMR company sells.

Are quality patient care and quality reimbursement mutually exclusive in an EHR?

I think it’s a bit much to say that they are mutually exclusive. I think you can have both. However, I think that very few EHR vendors have both right now. Hirdey is absolutely right that no doctor would buy an EHR if they didn’t take care of the revenue needs of a practice. That is the first feature that most doctors look for when looking at EHR software.

As in most parts of life, you get what you pay for. Doctors are willing to pay for something that will increase their revenue. That’s why the EHR incentives worked so good (even if it’s fuzzy math). They saw some government money and so they adopted EHR to go after the money. I can’t remember someone ever asking if the EHR would make them more effective clinicians. I can’t remember them asking if the EHR would help them provide better patient care.

It’s kind of sad thing that are reimbursement system is so disconnected from the quality of care a doctor provides. The good news is that now that reimbursement is tackled and meaningful use is tackled, I have hope that EHR vendors will start to differentiate themselves from other EHR vendors based on their clinical abilities.

What do you think? Are we heading for a new era of EHR that’s more focused on clinical and patient outcomes and less on maximizing reimbursement? Or at least that we’ll see both?

About the author

John Lynn

John Lynn

John Lynn is the Founder of the, 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,, 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.


  • Currently, the EHR is purchased at an institutional level. This means that the people (or committees) making the decision are rarely those who use it in a clinical setting. The primary voices at the table are IT, billing, administration.

    Until the job of the EHR is recognized as being primarily clinical, and the decision-makers about EHRs are primarily users (clinicians and patients), there is no reason to expect that the EHR will magically become a useful clinical tool.

    Even if IT, billing, risk management and administration wanted to develop a clinical tool, they would not be able to, any more than a plumber would be able to design a wrist watch or a violinist would be able to design a parking lot.

    The principle is that every system produces exactly the results it is configured to produce.

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