As a physician, you earned an MD, but probably not an MBA. But in today’s health care environment you have to run your practice like a business in addition to providing great patient care. It’s critical to have efficient staffing, minimize costs and maximize your reimbursements and collections. Here we present five ways in which an electronic medical record (EMR) can help you achieve these goals.

Stop paying staff to manage paper
How much time does your staff spend shuffling paper, searching for charts and translating illegible text? Have you considered how few office assistants you would need if locating a record were as easy as a Google search? By “going paperless” with an EMR, you can transform the way records are stored and retrieved. Instead of waiting for your assistant to run down the hall and locate a record from storage, you could access any chart, on-demand, with a few clicks of a mouse. Moreover, an EMR helps mitigate risk by protecting confidential information and eliminating the chances of losing a chart.

Major medical centers like the Beth Israel Deaconess Medical Center in Boston are on the leading edge of adopting new software technologies. Beth Israel sees over 750,000 patients a year and estimates they will save $6 million annually by reducing their dependence on paper records. Following this model, a practice seeing 3,000 patients annually could save $24,000.

Reduce malpractice insurance premiums
You may be surprised at what an EMR can do for reducing liability. Improving patient documentation, audit trails, and accuracy would not only reduce incidents of medical errors, but also improve your chances of receiving discounts from liability insurers. In a 2005 survey by the Medical Liability Monitor, a four-state average of the highest liability rates for OB/GYN was $230,919. With a two to five percent credit from malpractice insurance companies, clinics would save $4,600 to $11,500 per provider, per year, if they implemented an EMR.

In a current example, the Midwest Medical Insurance Company (MMIC) is offering a two to five percent credit to physician groups that use an EMR in 2008. With a board of directors that “strongly believes EMR software improves the quality of care through better patient safety,” the MMIC has set a precedent for other medical malpractice insurers to follow.

Stop downcoding and submit claims with confidence
Are you among the majority of physicians that downcode to avoid unsupported claims? While this ethical approach is to be lauded, you are likely cheating yourself of well-earned reimbursements. The coding capabilities in a modern EMR can guide you through the coding process and ensure you have documented each encounter properly to ensure proper reimbursement. An EMR can prompt you to input the right ICD-9 code for the diagnoses, as well as the right E/M codes for procedures, while simultaneously ensuring they correctly correspond with each other. Using pre-populated templates and values, EMRs assist in proper documentation during the patient encounter in order to support claims later. Overall, accurate coding speeds up the claims process and will result in fewer rejected claims from insurance companies.

Automated superbills also reduce the chance of missing out on revenues from collections. Similar to the coding process, EMRs can create a superbill during the examination, which can then be accessed immediately by back-office staff or billing services to finish the billing process. This eliminates the possibility of human error and lost paper documents.

Participate in pay-for-performance programs
Healthcare Pay-for-Performance (P4P) programs are showing up across the country. In addition to regional, non-profit organizations, there are a number of federal programs that provide bonuses for tracking a patient’s history and proving you made them healthier. One of the better-known programs is the Medicare Care Management Performance (MCMP) demonstration. The MCMP is a 3-year, pilot P4P program that encourages physicians to follow strict quality-control guidelines for treating chronically ill patients. During the first year of treatment, physicians receive bonuses for reporting data on quality measures. In the second and third year, participating clinics receive annual performance-based bonuses of $10,000 per clinician, as well as an additional 25% reward for using a CCHIT® Certified EMR.

To participate in a P4P program, you will need to track and measure your care, and monitor your efficiency of delivering quality care at the best cost. You must also document the patients’ experiences using post-exam surveys. Most EMRs are capable of meeting these requirements while simplifying the process. They provide context-sensitive information during the examination and alert physicians to next-step treatment options or additional preventative care diagnosis.

Get your EMR purchase subsidized
The benefits of an EMR are increasingly clear, but how can you afford the investment required to implement an EMR? Start by getting it subsidized. Many hospitals and regional healthcare systems can gain an exemption from Stark and anti-kickback laws to subsidize their physicians’ EMR purchases if:

• the EMR can exchange data with other EMRs;
• the EMR features e-prescribing functionality, and;
• the hospital doesn’t restrict the EMRs interoperability (i.e. the software can communicate with a system from a competing hospital).

Note that a hospital cannot pay for hardware, storage devices and software other than the EMR; and it can only pay up to 85% of the implementation cost.

Another option is to join a Regional Health Information Organization (RHIO). Created to support the Nationwide Health Information Network (NHIN) initiative and to develop a national health IT infrastructure, these organizations are magnets for state and federal grants, and provide frequent opportunities to finance an EMR. In 2006, the state of New York contributed $52.9 million in funding to create community RHIOs and increase use of interoperable EMRs. More recently, the state handed out $105 million to 96 hospitals in order to create a statewide EMR system.

Finally, as noted earlier, purchasing a CCHIT Certified EMR opens opportunities to “subsidize” your purchase through government payment programs and malpractice liability insurance discounts.

Conclusion
EMRs can help you realize significant cost savings and increase revenue for your practice. The initial investment is becoming more affordable and the return on your investment is compelling if implemented and adopted properly. With reduced operating costs, bonuses from malpractice insurers and P4P incentives, it makes sense to take a serious look at your EMR strategy.