Are Podiatrists Really Using EMR?
Given the potential benefits of quicker reimbursement and improved productivity, and the need to ensure HIPAA compliance, you would think electronic medical records (EMR) would be in place in the majority of physician practices. How many doctors are actually using the EMR Systems in the office? Not many, according to a recently published survey in the New England Journal of Medicine (NEJM). Over the last two years, researchers surveyed 2,758 physicians including various types of physicians who provide direct patient care. The authors of the NEJM article note that 4 percent of those surveyed have an extensive and fully functioning EMR system while 13 percent said they have a basic EMR system. Those who were more likely to use EMR included primary care physicians, younger practitioners, doctors in large groups or hospitals, and those in the western United States. Those who do use EMR told the researchers that they have high levels of satisfaction with their systems. Electronic medical record users also noted that EMR had positive effects on the quality of clinical decisions, communication with other providers and patients, prescription refills, timely access to medical records and avoiding medication errors, according to the survey. So why is there an overall reluctance to incorporate EMR? The present U.S. health system is “21st century medicine held together by 19th century paperwork,” says Caroline Fife, MD, quoting Tommy Thompson, the former Secretary of Health and Human Services. She notes that although the U.S. spends twice as much on healthcare per capita as Sweden, the Netherlands and the United Kingdom, those three nations have better overall health incomes. She attributes this to their modernized management of health information. In particular, more than 90 percent of Scandinavian doctors use EMR, according to Dr. Fife, an Associate Professor in the Department of Anesthesiology at University of Texas Health Science Center in Houston. In addition to EMR’s benefits of fewer redundant tests and procedures, and fewer treatment errors, Dr. Fife notes that EMR can increase patient volume as well as reduce practice overhead. She also notes that with EMR, podiatrists can have clinical practice guidelines at their fingertips at the point of care, which reduces delays in decision making. Bruce Werber, DPM, notes additional advantages of EMR. Dr. Werber, a Past President of the American College of Foot And Ankle Surgeons, cites improved documentation for protection against audits, better coding to enhance reimbursement and improved workflow. He also notes a potential decrease in office costs if electronic systems are correctly implemented and doctors and their staff are willing to “change old habits.” Dr. Fife notes further cost benefits. She says it has been estimated that widespread adoption of the technology can save an estimated $81 billion a year in the U.S. A Closer Look At The Hurdles To Incorporating EMR Of those 83 percent who reported not using EMR, 16 percent said they had purchased but not yet implemented a system, according to the survey. Authors of the NEJM article also say 26 percent of those surveyed intended on purchasing electronic systems in the next two years. Dr. Fife counters that a survey by the Health Information Management Systems Society found that 53 percent of surveyed practices are about to implement EMR. Financial considerations had the greatest effect on the decision not to implement EMR, according to the NEJM survey. Other barriers to implementation include not finding a system to meet one’s needs, uncertainty about the return on investment and concern about obsolescence. Dr. Werber concurs that cost is a hurdle for DPMs who want to implement EMR, particularly the cost of hardware and software. He suggests Web-based solutions are “the way to go” as they permit low-cost entry into systems and allow migration of collected data into other systems as technology changes. “It is incredible that physicians must bear the financial burden for these systems when the biggest beneficiaries are the insurance companies and government,” says Dr. Werber, who is in private practice in Mesa, Az., and serves as the Director of Clinical Education at Midwestern University in Glendale, Az.