Guest Blog Post by Kevin Brady, President of Physicians Angels.
There are over 1,000 Electronic Medical Records (EMRs) for use in physicians’ medical practices on the market today. The Centers for Medicare and Medicaid Services continues to push physicians to adopt EMRs in even larger numbers. EMRs exist in a market that was worth an estimated $2 billion in 2009, and is expected to grow to over $6 billion by 2015. EMRs are sold under the promise of delivering greater productivity and efficiency to physicians. But that is not happening. Why?
First, some background. An EMR is most simply defined as a digital version of paper-based medical record. Before EMRs, doctors recorded patient data on paper charts, which were stored at the doctor’s office. Doctors might have employed transcriptionists to help, as many still do. With paper charts, it is usually difficult and time-consuming for patients and their doctors to gain access to those files. EMRs have emerged as an advertised solution for doctors – a way to make doctors more efficient and make patient data-sharing easier.
One question looms large amidst this “EMR craze” though: Who is going to input, organize, and manage all of this patient data? To date, the answer has been, “Doctors and their staff, of course! They’ll just enter it into the EMR!” However, that approach has not worked out well for physicians, leading to reduced productivity and greater stress levels.
Studies by the medical practice management consultancy firm KarenZupko Associates found that, on average, a doctor documenting a patient visit via the old-fashioned pen-and-paper method took, on average, 2-3 minutes to complete a single patient chart. With EMRs, it takes, at a minimum, five minutes to complete the same patient chart. And for less computer-savvy doctors, it can take 10-15 minutes to complete the same chart. Physicians are reporting drops in their patient workloads from 35-40 per day, to 20-25 per day once they adopt an EMR. This negatively impacts a medical practice’s bottom line, while increasing everyone’s stress levels.
Doctors tend to blame their EMRs for making them inefficient. They complain about clumsy EMR user interfaces, too many difficult-to-find features and click boxes, and EMRs which are not specialty-specific. But blaming the EMR misses the larger point: How do doctors manage their time with an EMR? And to whom do doctors assign in the office to handle the $10-an-hour data entry chores required to manage well an EMR?
The investment in EMRs and healthcare mobile applications now needs to be matched by investment in staffing and a workforce to manage these new tools and the mounds of data they are producing. What we need are EMR data managers – also commonly known as medical scribes. There is a growing abundance of research and market validation supporting the use of medical scribes. Several companies already offer onsite scribes to physicians working in busy emergency rooms, and companies such as my own have emerged the past few years to work with physicians in clinical settings. Scribes can work on site or virtually – i.e., from a remote, HIPAA-secure location.
The healthcare sector needs to invest heavily in creating a new generation of healthcare workers to input and manage the data produced by thousands of EMRs, mobile apps, and other practice management platforms. This new generation of healthcare workers will help physicians better make use of their time with EMRs. Best of all for patients, medical scribes guarantee that they have the undivided attention of a physician in the exam room – instead of having to pay for an exam during which the doctor’s nose is buried in an EMR screen.