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The Curious State of EMRs in America: Nobody wants to be sold, but everyone wants to be helped


By Cecilia Kronawitter

For decades, the United States has established itself as a forerunner in the area of technology. This remains true in most capacities today, but not in the area of electronic medical record (EMR) systems and storage. With countries such as the United Kingdom, the Netherlands and New Zealand leading the way, the U.S. has fallen far behind, with merely 28 percent of its health facilities using these systems properly.1 Only an approximate half of all office-based physicians are even using EMR systems, with just more than 10 percent of those using them efficiently, effectively and fully functionally.

So, the question arises: What lies ahead for the future of EMR systems in the United States? With conclusive evidence pointing towards the benefits of implementing such a system in facilities, the reason why they are scarcely executed is perplexing. Hence, one might also ask: Why is there such a delay in the adoption of these systems? I believe the answer is simple – fear! People are apprehensive about going paperless with an EMR system. They do not want to be sold something new that is promised to be a “fix all" solution, without tangible proof that they will not be going it alone. Simply put, facilities want help. They want assurance of service once they have signed on the dotted line, after all of the promises have been made.

Whether it falls in the hands of an outside consultant or the sales representative from the software system, throughout the entire conversion process to the EMR system, the facility needs hand-held assistance from selection through training and implementation. Facilities want service that goes beyond a voice on the other side of the phone, giving them verbatim guidance and instruction. With proper facilitation and efforts in place from all members involved in this process, a successful and very gratifying implementation is achievable. This instrumentation process can prove to be a tremendous asset to the facility.

Despite the potential benefits, the majority of facilities remain hesitant to adopt or have previously selected systems that do not function as intended. Without moving forward in this process, the advantages of fulfilling this implementation to completeness will never be known; the endless remunerations your facility can attain by making the investment in its future continue to remain out of reach. By choosing to enact the change to go paperless, your facility will find value in the following:

Prompt Procedural Documentation

The patient information process starts the minute the patient is booked in the facility. From that point, information is entered at every stage – booking, pre-call, registration, pre-op, intra-op, post-op and discharge. The documents created at each phase are e-signed and time-stamped throughout this process. If there is any question, the answer can be found easily and promptly. By the time the patient leaves the facility, the chart is completed and signed. Even the letter to the referring physician is sent at the click of a button.

Ease of Report Generating

Simplifying the process will remove the fear of having all the medical records in electronic format. The ease of generating the necessary reports due to their electronic structure will quickly prove the time saved in this area.

Increase in Productivity and Efficiency

With the right EMR system in place, an increase in productivity and efficiency is attained as the patient moves more proficiently throughout the surgical experience. There is no time lost for documentation after the patient’s encounter is finished. Reviewing the complete patient chart and information is easy. No charts should be incomplete at the end of the day, and no one should have to review charts for completion and proper documentation hours after the patient has left the facility. After the patient has been discharged and the chart is finalized, this improved process leaves only billing to be completed. With that, adequate system backup is also a must and never to be ignored. Again, selecting the right system for the facility remains to be imperative.

Improved Communication

Having all of the patient medical history available to the physician, anesthesia provider and nursing staff, readily on hand in the patient electronic chart, provides prompt ease of access to information at the click of a button.

Enhanced Treatment Experience and Patient Satisfaction

A key enhancement to your facility once an EMR is used effectively is that the patient is allowed to move through the entire surgical process more expeditiously and with greater ease. A superior quality of care is delivered to the patient, in turn providing greater patient satisfaction. The patient then identifies that facility as a leader in technological advancement.

Reduced Margin for Error

Due to the timeliness and completion of patient charts, a reduced margin of error is evident, as the system will not be able to finalize the chart until all chart documents are completed in full. Patient health history, lab work and current medication lists are at the disposal of the providers, giving them additional capabilities when assessing patient health issues.

Meets Compliance Regulations

The new regulations require more documentation, forcing the need for the adoption of an EMR system to the forefront. Compliance with CMS, as well as licensure and accreditation with the chosen agencies, is achieved through the appropriate EMR selection with much ease.

Expedited Claims Processing

Having all procedures and surgeries finalized and e-signed by the attending physician at the close of each day of cases allows the biller to electronically file and submit the claim for each patient that very same day.

Better Cash Flow and Increase in Revenue

By sending the claim electronically the same day the procedure is completed, the process allows for a more expedient process of the claim. In turn, the facility receives timelier payments, thereby increasing its revenue stream.

Inventory Management and Cost Savings

Many of the EMR systems in existence today have an internal inventory management module. Utilizing this feature to its capacity will reduce several major problems facilities typically face. These include overstocking and waste due to the expiration of supplies. Both lead to significant overspending and together are responsible for countless dollars in profit leaving the facility unnecessarily.

EMR Reality Check

There is no one system out there that can be defined as a uniform solution for all facilities. There is no easy solution to identifying and choosing the system that is best suited for your facility. Each system requires proper evaluation in order to be perfectly matched to suit the precise needs of your facility, physicians and staff. But, if that first step can be achieved and the implementation process begins to flow, the possibilities are endless. The system will require maintenance and to be kept current with updates, as this is not a one-time installation.

Ensure that you do not get discouraged throughout this possibly lengthy process. Based upon the complexity of your particular facility, the length of time varies for your complete implementation process. Within the facility, trained personnel or an outside consultant must oversee this implementation – and additionally, the maintenance and updates – to ensure everything is completed properly and in a timely manner. It may seem like a lot at first, but when compared, the costs for paper records and storage far outweigh the costs to convert to an EMR system. Additionally, the value that is added to your facility by choosing to adopt an EMR system is infinite, further simplifying the choice. The majority of facilities are able to recoup the initial investment in less than five years.

Although the journey to go paperless may seem challenging, with the proper support to enable and simplify the conversion, the decision to implement an EMR is destined to be a success.

Cecilia Kronawitter, president of HDA Enterprises Inc. ( ), is experienced in designing, developing, managing and marketing healthcare facilities. Most recently in her endeavors, Kronawitter expanded her business expertise to that of “paperless facilities" and the implementation, integration and interfacing of EMR systems. She feels the world is trending towards EMRs being a standard – and that the future of the healthcare industry is paperless.

1Tera Tuten – - EHR/EMR Facts and Amazing Statistics. Nov. 3, 2011. “The U.S. Trails Most Other Developed Countries in EHR/EMR Implementation."

A portion of the article's title was adapted from John Maxwell – Everyone Communicates, Few Connect: “What The Most Effective People Do Differently"


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