Anatomy of a Successful EHR Adoption

By Nelson, Rosemarie | Medical Economics, December 25, 2012 | Go to article overview

Anatomy of a Successful EHR Adoption


Nelson, Rosemarie, Medical Economics


How do you measure success? Some would suggest that we must determine the return on investment before we sign a vendor contract for an EHR acquisition. That task may be overwhelming considering that we dont often understand the costs of our current operations.

Greg Spencer, MD, chief medical officer of Crystal Run Healthcare, a group practice in New York with about 200 physicians, says, "Paper costs money, too, but that feels more like a 'normal' expense."

And therein lies the dilemma: What is the new normal?

Let's look at the story the data tell us.

Looking at the table "Orthopedic surgery, median per FTE physician, 2010 report" (numbers rounded), at first glance, we might point our fingers at the higher head count for orthopedic surgery practices using an EHR. Look further, however, and the EHR practices produce more relative value units (RVUs) and generate a higher percentage of medical revenue after operating costs than practices in the paper environment or those that are operating in a hybrid setting.

The table "Multispecialty, not hospital-owned, median per FTE physician, 2010 report" addresses the question: Do multispecialty practices using an EHR with more support staff per FTE physician use their staff more effectively as represented by more RVUs per FTE physician?The increased production would support a higher percentage of medical revenue after operating cost, and that includes the cost of the additional support staff.

The table "Multispecialty by years EHR in practice, median per FTE physician, 2010 report" points to experienced EHR practices realizing the most significant benefits in the form of a higher percentage of medical revenue after operating costs and increased production as measured by total RVUs. The efficiencies of the EHR allow us to see more patients and provide more services, a win-win situation for the patient and the practice.

The table "Family practice, median per FTE physician, 2010 report" (again, numbers rounded) depicts family practice data that raise the question of staffing to support the provider. Do practices enter into the EHR implementation without appropriate staff to support the transition and adversely affect production?

It would appear that billing and collections operations are significantly enhanced with the use of the EHR in family practice. …

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