Finance Slide Show
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79158502-hca270-hca-270-version-3-final-project-implementing-emr.pptxELECTRONIC MEDICAL RECORDS IMPLEMENTATION
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Why to use New System?
Electronic Medical Records
Medical Record Errors
Illegible handwriting
Medical Abbreviations
Handwritten medical notes
Accuracy
But is costly
Training
Setting up software
There are various reasons as to why medical abbreviations are not used any more in the hospitals. One of main reasons is the medical errors. Stopping the medical abbreviations use helps in reducing medical errors. Though this does reduce some medical errors, but still there are mistakes that do exist. There may be some charting errors that could be minimized by keeping a person to check through before submitting the record. This would, however, cause to increase scheduling time and thereby increase the cost through overtime. The most productive way to deal with this would be a computerized system where patients’ charts and notes are placed. Like in other programs, a red flag could be used to question any medical abbreviations and the medical staff has to accept this before proceeding. The system would be a bit expensive but would be hassle free from inaccuracy and having to undergo lawsuit for malpractice. Electronic Medical Records are thus the best means to reduce medical errors.
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Steps for Implementation
Choosing Software
Choosing Vendor
Testing
Training
Support
Beginning of this year, a testing of Practice Partner Patient Records was tried. This software was chosen as it provided a set of new innovative tools for improving efficiency of the office and clinic along with improving the quality of care. The software helps to replace the paper charts with a completely intuitive and user-friendly interface with built-in security. This easy-to-learn and easy-to-use EHR system is suitably enough for any office (Sunrise Services, 2005). This software was installed in one of our clinics with 14 examination rooms and 2 treatment rooms. In terms of staffs, there are 8 full-time physicians, 2 part-time physicians, 2 Certified Physician Assistants, 2 fulltime lab technicians, 26 full- and part time office and medical staffs. There are around 15,000 patients annually visiting the clinic.
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Financial Pros and Cons
Capital Expenditure
Long-term improvement Costs
Medical equipment expenditure
Very costly lawsuits
Electronic Medical Records will reduce medical errors
To shift to paperless system, we do need to have sufficient capital. Though most medical personnel voiced using Electronic Medical Records, there is still in need of convincing a large group of people on why we require Electronic Medical Records. The privacy and security of the patients are the growing concerns in regards to Electronic Medical Records. It would follow HIPAA guidelines. The Electronic Medical Records would definitely help to reduce medical errors, thereby decreasing hassles of expensive lawsuits. The Electronic Medical Records allows us to provide patients with the latest technology in healthcare sector.
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Financial Pros and Cons continued
Current value
value of a future payment on a given date
Definitely financial gain - Huge saving on implementing an EMR
Reduction in
Lawsuits
Undesirable Drug Events
Needless medical testing
Additional hospital stays
Unapproved claims
The studies regarding financial effects through Electronic Medical Records have not been conducted much, though some studies are available. One of such study was conducted in ambulatory setting. The collected data showed that on approximately 86,400 savings to the healthcare provider on an average in 5 years’ time period. This saving came from expenses in drugs, reduction in expenses in radiological testing, reduction in errors in billing and improved billing charge capturing system (Wang, 2003). The study also showed that the Electronic Medical Records prevented 47,000 undesirable drug events.
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Financial Pros and Cons continued
Projected Revenue
to estimate what will the revenue be
Electronic Medical Records save expenses by
Reduction in
Office personnel and staffs
transcriptionists
chart storage cost
Enhances
emergency room coding
evaluation and management coding
Today’s advanced technology allows medical personnel accessing the medical records from their clinics or hospitals or even from their homes. The medical doctors even can have video conference or chat with specialists residing in different state, city or country for improving the quality of healthcare service they provide. There is added advantages and financial benefits with the implementation of Electronic Medical Records. It eliminates the chart storing area and expensive paper files. It helps in increasing revenue through improved evaluation and management coding system. The financial benefits arises from the increased revenue and reduced operational costs, right from the first year of its implementation. The study also showed that there is approximately 8.2 million financial saving over the 5 years’ time period.
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Financial Pros and Cons continued
Opportunity Costs
The cost of passing the next best choice when acquiring a decision
One option vs another option
Implementation cost
Comparing financial loss in each options
Installation of an Electronic Medical Records system in a clinic costs approximately $45,000 per full-time physician. The initial setup cost is $45,000 per physician along with $8500 yearly maintenance cost of the system and approximately $25,000 for the training. During the negotiation, extra training can be placed as a condition for purchasing and installing the EMR System. It is projected that we could regain the cost back from the system in 2 ½ years with a profit of $23,000 per physician. There are some drawbacks too with the installation of the system. There would be decrease in patient seen per day for the first month as it would take some time to get into the system and use it and the number of patient would then increase. Another issue is hardware cost which may account up to $140,000 or more along with software for lab. Apart from this, there would also be bugs to work out with.
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Financial Pros and Cons continued
Overall Costs
Costs required to implementing EMR
Hardware
Software
Training
staff
support
user friendly
It is very necessary that we do study on Return on Investment before we do any purchase decision. It is more so for Electronic Medical Record system as the installation cost is pretty high and may vary from one company to the other. For an instance, if a physician checks 30 patients a day with around 2500 active patient base. Now taking a ratio of 3:1, the clinic receives approximately 100 calls per day for appointment, medication refill, billing request and other queries. The license on Electronic Medical Records software ranges from $1,000 - $25,000 with an average of $10,000 for a license of full Electronic Medical Records system while an entry level system costs around $1,000. The implementation costs ranges from $75 to $150 an hour. The average implementation time is about 35 hours. The training hours is of 35 out of which 10 hour is for actual computer training and 10 hours for customizing the system so as to fit the organizational need. Higher the number of physician, lower will be the overall cost of implementation cost. To make it more clear, let’s see an example. Let’s assume an hourly rate of $100 and the assistant ratio 3:1. We are assuming that every provider has an IPad costing $1000, a server costing around $2,000, and a room accommodating 3 nurses costing up to $1,000. Apart from these, there is recurring annual maintenance cost to be contracted with the vendor which would cover for both technical support along with software updates. Then, there would be a need of local IT guy who would deal with other technical issues with hardware or the network as required.
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Surprise costs
Legal Threats
Reduction in Lawsuits
Lifetime storage
Maintenance
Yearly maintenance cost
Increase in utility bill
Though the initial set up cost for an Electronic Medical Records system is pretty high, we can save lots of time any money in the long run that is spent on charting files, arranging papers, filing personnel, storage area and fees and salaries. The cost for filling charts and billing of all the patients would keep on increasing. With the implementation of EMR, the legal threats decreases since all the information could be stored for a longer period should lawsuits do arise. There is also power consumption increment and yearly maintenance associated with the EMR software implementation that would increase expenses.
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Incentives
Federal grants
Medicare incentives
Tax credits
Software stimulus packages
There are some financial supports given by government for setting up Electronic Medical Records system. There are even federal grants supporting financially the Electronic Medical Record system. There are Medicare incentives of up to $44,000 or Medicare up to $63,750 for the significant use of certified EMR software system (Medical Software and EMR/EHR Software). Tax credits for 2011 equals to sum of about $250,000 with a depreciation bonus of 50% (Medical Software and EMR/EHR Software). The government is showing keen interest in decreasing medical errors through the Electronic Medical Records system use. There is lots of information regarding Electronic Medical Record system which one must read and select the one that suits the facility the most. The benefits of EMR implementation is the financial incentives provided through different agencies, reduction in expenses of initial capital and the increased efficiency with tie implementation of EMR system.
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Review
Advantages
Patients
Improved healthcare
Accuracy
Faster treatment & decisions
Organization
Transferring patient information
Increased number of patient seen daily
Reduced operational costs
Let’s look at some of the advantages from the patients’ perspective. From the patients’ point of view, they get improved diagnosis and faster treatment. Considerably less errors in the patients’ clinical records. The decision of treatment plan and healthcare are faster and better from the physician assigned to them.
From the viewpoint of the physicians’ point of view, the transfer of data from one department to other is faster and efficient. It’ll also help to increase the number of patient seen per day. The significant advantage comes from the reduced operational cost like transcription services and salaries (Pros & Cons of Electronic Medical Records).
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Review
Disadvantages
Patient
Privacy
Distractions
Reduced personal touch
Organization
Costly
Maintenance
Training
There is high concern regarding patient information security. If the patient’s personal information is leaked, it would be violation of HIPAA laws. Since the physicians type out the information in computer, the personal touch between physician and patient is lost or reduced. Some even believe the computer becomes a distraction between physician and patient, making the patient feel they are less cared than they are seeking or deserve. Apart from these, the EMR system is expensive, as have been discussed throughout the presentation. Training of medical personnel to use it makes it further costly. So is for the maintenance, updates and technical support. Some of the people don’t even adapt to technical changes so easily and they don’t prefer to change.
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Conclusion
There are various advantages on implementation of an Electronic Medical Record system. There are some disadvantages associated with it too. Electronic Medical Records helps to improve patient healthcare. Electronic Medical Records are not misplaced like paper files or records. The information kept in Electronic Medical Records is far more accurate and legible compared to paper record ones. Potential human errors are reduced considerably through Electronic Medical Record system as opposed to paper charts entered manually. Some of the medical staffs would not prefer using EMR System as they are less adaptive to the technology changes and would be overwhelmed using computerized system entering the medical records. Since the initial set up cost is high, there is loss of revenue at the initial phase though it has many positive gains. EMR not only maintains the information but also organizes these for further use. EMRs can also be used as guides for providers for their daily rounds. To sum up, EMR implementation will provide best healthcare possible to the patients.
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References
Reference:
Choosing an EMR: Pricing and Cost. (2008). Retrieved -------------, from Medscape news: http://www.medscape.com/viewarticle/571849_3
EMR Costs. (2011). Retrieved November 2, 2011, from EMR Consultant: http://www.emrconsultant.com/education/emr-costs
EMR ROI (Return on Investment). (n.d.). --------------------, from EMR Experts: http://www.emrexperts.com/emr-roi/index.php
Gurley, L. (2004). Advantages and Disadvantages of the Electronic Medical Record. Retrieved ----------------, from American Academy of Medical Administrator: http://www.aameda.org/MemberServices/Exec/Articles/spg04/Gurley%20article.pdf
Medical Software and EMR/HER Software (n.d.). ----------------------, from MDS Medical Software: http://www.mdsmedicalsoftware.com/
Pros & Cons of Electronic Medical Records (n.d.). -----------------from Micro MD: http://www.micromd.com/emr/advantages.html
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References
References:
Smith, P. (2003, May). Implementing an EMR System: One Clinic’s Experience. Retrieved --------------------------, from American Academy of Family Physician: http://www.aafp.org/fpm/2003/0500/p37.html
Stein, L. D. (1997). The Electronic Medical Record: Promises and Threats. Retrieved ------------------, from Oreilly: http://oreilly.com/catalog/wjsum97/excerpt/
Sunrise Services. (2005). Retrieved ----------------, from Practice Parteners Electronic medical Records: http://www.ppemr.com/
Wang, S. (2003, April 1). A Cost-Benefit Analysis of Electronic Medical. Retrieved --------------------------, from http://www.tss.dsu.edu/sdehra/documents/WangEMRCostBenefit.pdf
Weil, I. S. (n.d.). Top 10 Factors to Consider Before Purchasing and Implementing and EMR System . Retrieved -----------------, from The Camden Group: http://www.thecamdengroup.com/pdfs/Weil_EMR_Consider_Before_Purchasing_and_Implementing_EMR_System.pdf
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