Storage and Retrieval:
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The Electronic Medical Record may consist of computer order entry, decision support, electronic medication administration, documentation, and so much more. When compared to paper charts, Electronic Medical Records (EMRs) have many benefits and return on investments (ROIs).
Following is a brief discussion of some of those benefits and ROIs.
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The Electronic Medical Record may consist of computer order entry, decision support, electronic medication administration, documentation, and so much more. When compared to paper charts, Electronic Medical Records (EMRs) have many benefits and return on investments (ROIs).
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== Efficiency ==
== Efficiency ==
EMRs improve clinical efficiency in multiple ways:
EMRs improve clinical efficiency in multiple ways:
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It stores all the patient’s
data, including but not limited to, patient medical history, medication history, vital signs, lab tests results, as well as other pertinent information in a single location, and is readily available to anyone directly involved in the patient’s care, regardless of location. It eliminates time and cost from paper chart pulls and transcription and re-file of paper charts (Wang at al, 2003).
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#
EMRs store patient
data, including but not limited to, patient medical history, medication history, vital signs, lab tests results, as well as other pertinent information in a single location, and is readily available to anyone directly involved in the patient’s care, regardless of location. It eliminates time and cost from paper chart pulls and transcription and re-file of paper charts (Wang at al, 2003).
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It reduces
the likelihood that tests will be unnecessarily duplicated.
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#
They reduce
the likelihood that tests will be unnecessarily duplicated.
# Coordination of care is easier to achieve and eliminates steps that may lead to discrepancies in the sharing of data.
# Coordination of care is easier to achieve and eliminates steps that may lead to discrepancies in the sharing of data.
# EMRs can promote early intervention in disease processes because all the health data- vital signs, lab results, imaging, physician notes, nursing notes, etc.- of a patient are accessible in the same record (6).
# EMRs can promote early intervention in disease processes because all the health data- vital signs, lab results, imaging, physician notes, nursing notes, etc.- of a patient are accessible in the same record (6).
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EMRs
are vital to improved quality of care at the bedside or point of care because less time is spent doing non-caring activities and more time spent actually caring for the patient (6).
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#
They
are vital to improved quality of care at the bedside or point of care because less time is spent doing non-caring activities and more time spent actually caring for the patient (6).
# EMRs reduce the number of lost or missing reports.
# EMRs reduce the number of lost or missing reports.
# They reduce variability of care.
# They reduce variability of care.
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== Storage and Retrieval ==
== Storage and Retrieval ==
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EMRs improve the storage and retrieval in
these
ways:
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EMRs improve the storage and retrieval
of patient information
in
the following
ways:
# Reduces the amount of physical storage space required to house charts.
# Reduces the amount of physical storage space required to house charts.
# Protected from fire, natural disaster, or theft.
# Protected from fire, natural disaster, or theft.
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EMRs can decrease the fragmentation of care by improving care co-ordination among clinical and administrative staff. Better care coordination can improve transparency among overall processes. EMRs have the potential to integrate and organize patient health information and communicate this information accurately among everyone that is involved in a patient's care. Better availability of patient information can reduce medical errors and redundancy in health care.
EMRs can decrease the fragmentation of care by improving care co-ordination among clinical and administrative staff. Better care coordination can improve transparency among overall processes. EMRs have the potential to integrate and organize patient health information and communicate this information accurately among everyone that is involved in a patient's care. Better availability of patient information can reduce medical errors and redundancy in health care.
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'''Increased practice efficiencies
and
cost savings'''
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'''Increased practice efficiencies
,
cost savings
, and reimbursement
'''
EMRs help improve medical practice management by increasing practice efficiencies and cost savings. A practice can be made more efficient by using integrated EMR systems that can be used for scheduling, automated coding, and managing claims which save time as well. As one example, a clinic or physician practice can expect to increase revenue and decrease costs by converting the encounter form to digital format to reduce billing errors and revenue loss. Prompts for fields that need to be completed will reduce errors by an average of 78% according to one study [40]. Communication is enhanced among clinicians, labs and health plans as information can be accessed from anywhere. EMRs save money by reducing redundancies in medical care, by eliminating costly tasks of creating paper charts and labor intensive management of paper charts. Very simply, the EHR eliminates paper chart pulls and staffing expenses can be reduced as a result. One study estimated that an average of $5 per pull would be saved considering the time and cost of medical records staff to retrieve and then re-file the paper chart. The clinic studied expected it would reduce paper chart pulls by approximately 600 annually and transcription costs would be reduced by 28% [41].
EMRs help improve medical practice management by increasing practice efficiencies and cost savings. A practice can be made more efficient by using integrated EMR systems that can be used for scheduling, automated coding, and managing claims which save time as well. As one example, a clinic or physician practice can expect to increase revenue and decrease costs by converting the encounter form to digital format to reduce billing errors and revenue loss. Prompts for fields that need to be completed will reduce errors by an average of 78% according to one study [40]. Communication is enhanced among clinicians, labs and health plans as information can be accessed from anywhere. EMRs save money by reducing redundancies in medical care, by eliminating costly tasks of creating paper charts and labor intensive management of paper charts. Very simply, the EHR eliminates paper chart pulls and staffing expenses can be reduced as a result. One study estimated that an average of $5 per pull would be saved considering the time and cost of medical records staff to retrieve and then re-file the paper chart. The clinic studied expected it would reduce paper chart pulls by approximately 600 annually and transcription costs would be reduced by 28% [41].
There is significant evidence to show that while initial costs remain an issue, switching from paper records to EHR systems will ultimately reduce overall health care expenses. Research indicates that Medicare and private payers could save tens of billions of dollars every year. To incentivize EMR adoption, the federal government has established a plan to provide $44.7 billion during 2010-2019 to financially assist health care providers in the EMR implementation process [4]. However according to Himmelstein, Wright & Woolhandler, as currently implemented, the use of Electronic Medical Records could moderately advance metrics related to quality measures, it does however not reduce the cost of administration of ‘overall’ costs. “Hospitals on the ‘Most Wired’ list performed no better than others on quality, costs, or administrative costs” (Himmelstein, Wright & Woolhandler, 2009). Forecasts of potential improvements in efficiency and cost-savings from implementation of computerized health care and the use of Electronic Medical Records seem premature at the time the authors published their data in 2009 [12].
There is significant evidence to show that while initial costs remain an issue, switching from paper records to EHR systems will ultimately reduce overall health care expenses. Research indicates that Medicare and private payers could save tens of billions of dollars every year. To incentivize EMR adoption, the federal government has established a plan to provide $44.7 billion during 2010-2019 to financially assist health care providers in the EMR implementation process [4]. However according to Himmelstein, Wright & Woolhandler, as currently implemented, the use of Electronic Medical Records could moderately advance metrics related to quality measures, it does however not reduce the cost of administration of ‘overall’ costs. “Hospitals on the ‘Most Wired’ list performed no better than others on quality, costs, or administrative costs” (Himmelstein, Wright & Woolhandler, 2009). Forecasts of potential improvements in efficiency and cost-savings from implementation of computerized health care and the use of Electronic Medical Records seem premature at the time the authors published their data in 2009 [12].
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EMR implementations could affect physician and health system reimbursement in a number of ways. Some have argued that increased clinical documentation as a result of using an EMR will lead to increased billing and therefore reimbursement. An increase in emergency department billing among Medicare patients has been attributed to more complete documentation that allows for higher levels of billing [43]. However, given the pay-for-service model present in many facets of the American healthcare system, some of the cost savings possibly generated by the introduction of an EMR – such as eliminating unnecessary and duplicated tests and ineffective procedures – could lead to decreased reimbursement for the physicians and health systems.
== Return on Investment (ROI) ==
== Return on Investment (ROI) ==
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==Reducing cost==
==Reducing cost==
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EMR can help hospitals or patients to reduce some redundant tests. For example, EMR could reduce the number of tests conducted at KCH by 7% according estimate by Julia Driessen’s report. A 1998 study at Brigham and Women's Hospital concluded that 8.6% of the tests sampled were redundant, and if those tests were not performed, charges would be reduced by $930,000 annually.
(30)
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EMR can help hospitals or patients to reduce some redundant tests. For example, EMR could reduce the number of tests conducted at KCH by 7% according estimate by Julia Driessen’s report. A 1998 study at Brigham and Women's Hospital concluded that 8.6% of the tests sampled were redundant, and if those tests were not performed, charges would be reduced by $930,000 annually. (30)
A review of studies looking at possible benefits of CPOE found significant evidence of reduced laboratory test ordering in multiples studies [38].
Also, by SWOT analysis performed by Sameer Kumar. He said that nationally applied EMR can reduce paper to maintain medical records about 1.3 billion with a cumulative savings over 15 years of $19.9 billion.
Also, by SWOT analysis performed by Sameer Kumar. He said that nationally applied EMR can reduce paper to maintain medical records about 1.3 billion with a cumulative savings over 15 years of $19.9 billion.
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# Wang, Middleton, Prosser et al. (2003)
# Wang, Middleton, Prosser et al. (2003)
# Kaushal, R.; Jha, A.K.; Franz, C. et al. (2006) J Am Med Inform Assoc 2006;13:261-266 doi 10.1197/jamia.J1984
# Kaushal, R.; Jha, A.K.; Franz, C. et al. (2006) J Am Med Inform Assoc 2006;13:261-266 doi 10.1197/jamia.J1984
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# http://www.nejm.org/doi/full/10.1056/NEJMp1211315#t=article