HCA 360 Topic 8 DQ 1
It is realistic to expect that by 2020, more than 70% of physicians will integrate EMR technology into their practices. This is in response to existing national payment policies that make the use of medical record systems a standard for Medicare and Medicaid reimbursement. These new policies are expected to have implications for HMIS systems as well. The technological changes have been driven by many factors such as the need for interoperability with other EMR certification requirements and to reduce the cost of healthcare.
The number and size of small practices has increased dramatically over the last decade, while their reliance on paper medical records continues to increase at a high rate. This has created an even more urgent need for electronic medical record adoption in both large and small practices.
The rapid rise of EMR in the healthcare industry has helped make it easier for physicians to manage their outpatient practices more efficiently. Electronic medical records (EMR) allow physicians to view patient histories and compare imaging results, blood test results and lab results. They can also monitor when medications are due for refills, track immunization schedules and set up reminders for patient appointments.
It is likely that many small practices will adopt EMR and HMIS in the next 5 years. Small practices that have either recently purchased EMR or that plan to purchase it will benefit from purchasing it sooner. The sooner a practice has current technology, the better its chances of lowering costs associated with transitioning to an EMR system.
Michael Lewis (1994), a writer for the New York Times, compared the current computerization of medicine (at the time) to the introduction of electricity. Lewis argued that much of American medicine was moving from the business world into the technical world during this rise in the use of technology. He stated, “But just as electrification seemed at first to be a radical change in our society, an upheaval creating new jobs and industries from whole cloth…computers have already had a dramatic effect on every aspect of American medicine” (Lewis, 1994, p. A1).
Growing demand for more cost-efficient healthcare delivery options will drive development and adoption of electronic medical records (EMRs) and Healthcare Management Information Systems (HMISs) among smaller physician practices in the next five years. Greater regulatory requirements will impact all physicians with changes such as the ICD-10 mandate for compliance starting in 2013. Moreover, reimbursement changes have emphasized the greater need for doctors to decrease costs and improve health care efficiency through improved documentation, increased attention to patient safety issues and outcomes, and better management of chronic disease. These EMRs are not only beneficial to physicians but also represent a great opportunity for vendors who can provide effective solutions that are both financially feasible and technologically feasible.
The Meaningful Use Incentive Program, described as one of the “largest voluntary initiatives in history,” is a government-driven program that aims to get more doctors and other healthcare providers to adopt electronic medical records (EMR) and health IT. While the meaningful use program was originally established for physician’s offices in the United States, by 2016, any eligible provider can receive a cash reward through the program’s EMR incentive payment track. According to a 2012 Deloitte Center for Health Solutions survey, 43% of eligible physicians were registered for meaningful use. In 2014, that number dropped to 36%. This drop only accounts for active participation; not all US physicians are eligible to register with meaningful use since they haven’t hit that 90 day retention requirement exclusion period.
Recent work by the Advisory Board Company and Decision Resources, Inc. has illustrated that implementing EMRs and HMISs within small practices is more likely to occur than practices adopting other technologies – such as health IT networks, specialty drug programs and PCMH implementations.
The current demands on physicians for the implementation of electronic medical records (EMR) and health management information systems (HMIS) clearly indicate how small practice decision-makers perceive the costs and risks of EMR (Fairman & Goodman, 1996; Leape & Berwick, 1993; Kao, 2004). They require small practices to make a considerable investment in hardware, software and professional services such as programming and training.
The timeframe is critical. Most small practices have no interest in these technologies until they are forced to by the government, payers or other entities. Adopting these technologies becomes more costly and burdensome toward year 3 of retirement. The threshold for their adoption under current market conditions is an average net cash flow of 4% or greater per month, demonstrating the need for a clinician to protect himself by increasing productivity beyond the levels he demonstrated during residency. This requires clinicians to look at ways to increase patient census, expand their range of procedures beyond what they have been comfortable with, or develop rapport with new physician colleagues who would value and assist them in meeting their immediate and future economic needs.
[[[ In today’s world of business, competition is quite tough due to increasing population. This has led to the use of expensive electronic medical records in the health care sector. Small practices are adopting electronic medical records and health management information systems at a higher rate than practices with more than 100 providers. Physicians in small practices are likely to adopt EMR than larger practices because:
Given current demands on physicians, how likely is it that over the next 5 years most small practices will adopt EMR and, potentially, HMIS? What are some of the factors that might influence these investment decisions? State your views and support your assertions with examples and references.