DyMedisys - Dynamic Healthcare Solutions

Reprinted from: DyMedisys.com 1601 N. Sepulveda Blvd. #727, Manhattan Beach, CA. 90266, 800-529-3962

“The US population is enamored with science and technology and they want their physicians to be technologically savvy. By and large, however, the public does not associate family physicians with science and technology.”

Excerpt from March/April Annals of Family Medicine 2:S33-S50 (2004) Future of Family Medicine
Annals of Family Medicine, Inc.
…Family physicians will rely increasingly on information systems and electronic health records to provide assessments, checklists, protocols, and access to patient education and clinical support. Clinical information must be maintained in formats that allow for ready search, retrieval, and transfer of information while protecting patients’ privacy and the confidentiality of their medical records. Electronic health records with a relational database design and meeting national technical standards are essential. The paper medical record can no longer provide the needed foundation for the clinical care and research of family physicians.

Excerpt from March/April Annals of Family Medicine 2:S33-S50 (2004) Future of Family Medicine
Annals of Family Medicine, Inc.
Recommendation 1.3. Family medicine should develop and adapt into practice electronic health records and other technologies and systems of care that standardize and enhance (1) communication, (2) diagnosis and treatment, (3) measurement of processes and results, and (4) on-going relationships between family physicians and their patients to make family practices sufficiently robust to provide definitive care for a large portion of the problems that people bring to their family physician.

Recommendation from March/April Annals of Family Medicine 2:S33-S50 (2004) Future of Family Medicine
Annals of Family Medicine, Inc.
Paper records are estimated to cost approximately $8.00 per record per year to maintain, while electronic records can be maintained for $2.00 to $3.00 per year.
Time saved documenting visits approximates 2 hours per day. If converted into additional patient visits (assuming $50/visit), you net $81,000 per year per physician.
Cost to pull a chart is approximately .75 cents and the cost to create a new chart is approximately $2.00 depending on the type of chart folders, tab dividers, paper, paper punching, and labels.

Now you can eliminate that action and probably one or more staff members because the charts are available anytime and anywhere from the network.

Multiply the pulling of charts by the number of patient visits and the number of charts by material cost per chart, and you can see the large savings. For example, 10,000 annual patient visits amount to about $7,500 saved in chart pulling. If 30% of those patients are new, that's 3,000 patients times $2 per new chart materials, or another $6,000 saved. Add maybe another $1 in materials for the remaining patients, and the total savings exceeds $20,000 a year.
Correct E&M coding can add an additional $9 per visit on average (study performed at Northwest Diagnostic's). Based on typical patient volume and workload, this gain is approximately $56,000 per doctor per year.
After 12-18 months, conversion from paper to electronic medical records should be complete, bringing a cost savings of $6/chart/year. This efficiency gain goes right to the bottom line, saving $18,000 per doctor per year.
If they are to be successful, physicians will need information and automated tools to support the management of health care resources and spending. Historically, health care has under-invested in information systems relative to other industries (IS spending in health care averages 2% of costs compared to 8% in banking and finance), but over the next decade we will see a significant commitment to IS spending in this market. This new investment will focus on physician-based health information tools with an estimated $4 billion market potential in ambulatory clinical systems and another $9 billion in clinical data analysis systems.
Eliminated transcription costs, estimated to save each doctor approximately $12,000 per year.
According to the Robert Wood Johnson Foundation and the Institute for the Future Health and Health Care 2010 forecast, IT will be one of the biggest catalysts of change in the health care industry over the next 10 years. EMRs are expected to be one of four areas where health care will be most affected by IT.
Drastically reduce wasted time with denied claims, saving hundreds of hours per year for a physician's staff. Estimates range from a low of $1,500 per doctor per year to as high as $10,000 per doctor per year when claims are not resubmitted within the 90-day limit specified by most insurance carriers.
Automated charge capture 'discovers' lost charges. Conservative estimates claim physician owned clinics lose $10,000 per year by this mechanism. Hospital owned clinics lose about $75,000 per doctor per year.
Of the 738,000 licensed physicians in the USA, the majority work alone or with one or two other physicians. According to the AMA, only 33% of physicians participate in a group of 3 or more physicians.
It's estimated that up to 40 minutes of each clinic staff hour is spent re-evaluating priorities and performing rework generated by unexpected scenarios or miscommunications.
Fast food outlets are more computerized than the typical doctor's office.
Physician offices get approximately 10 requests for prescription refills per day per physician.
25% of drug prescriptions are never filled.
Cost savings from networked physician offices and electronic exchange of information would result in 30% drop in office costs and 50% savings on health plan administrative costs, which consume 10-12% of every premium dollar. (Gary McIlroy, MD, CEO of Health Risk Management).
Physicians direct about 85% of the $1 trillion spent on healthcare each year.
Less than 5% of integrated healthcare delivery networks have electronic medical records that are being used by several different providers. (Tower Perrin analyst, Arthur Saunders)
William Bates, MD, president and CEO of BAI Clinical Software, a developer of specialty-based EMR software, predicts EMR adoption rates will increase as high as 50 percent within the next five years.
"An AAMC survey of 1999 medical school grads found that 85% of respondents are comfortable using the Web to find information, and nearly three-quarters feel well prepared to use a computer-based clinical records system. And while in 1988 only 31% of medical school graduates felt that they had been adequately taught to use computers, that number has climbed above 70% in recent years." (http://www.ama-assn.org/)
The annual cost of healthcare record keeping is approximately $200 billion.
According to the Medical Records Institute, data capture -- particularly transcription -- for paper-based record keeping costs the health care industry approximately $15 billion annually.
HealthPartners, Minnesota's third-largest health system, uses a fleet of minivans to haul patient records between its 25 clinics and hospitals.
30% of patients' chart pulls are to look up test results.
Up to 70% of iatrogenic adverse drug events are preventable.
The pharmaceutical research firm IMS Health supplied data analysis services and the consulting firm Cap Gemini Ernst & Young confirmed the findings. The study, involving 1,200 physicians, showed savings of up to $3.29 per electronic prescription, compared with the cost of a paper-based prescription. Much of the savings resulted from enhanced formulary compliance and increased utilization of generic drugs.

Using software, however, changed physician-prescribing patterns, the study concludes. The prescribing of generic drugs was at a rate of 55% using the software, versus 43% in a control group that prescribed only on paper. When not using the software, physicians reverted to the same 43% generic prescribing rate as the control group. Using software also demonstrated 96% compliance with payer drug formularies, compared with an industry average of 85% to 89%. (Oct. 27, 2000)
"Coding errors by doctors to Medicare alone amounted to $1.5 billion in 1999, $1.7 billion in 1998 and $1.1 billion in 1997", according to a February 2000 report by HHS' inspector general's office. "For most of the coding errors found, doctors were overbilling."
"Industry observers acknowledge coding accuracy is a problem but say the issue involves undercoding as well as upcoding".
According to Debi Croes of the Croes Olivia Group, a practice management firm in Burlington, Mass. "Contrary to the inspector generals findings, Croes says that most of the doctors she works with "deliberately undercode" in the mistaken belief that they will reduce the possibility that they may be investigated. But ironically by doing so, they draw attention to themselves, she says.
"Automated order entry," David Bates, M.D says, " is the most potent strategy [for reducing medication errors] identified to date." Hard to read prescriptions are no longer acceptable, according to a Texas jury in November of 1999 who imposed damages of $225,000 each against a physician and pharmacist for writing and filling an illegible prescription.
Without an EMR, without this technology, we would have to continue to rely on physicians, pharmacists and nurses to be fully aware of all the drug interactions and all the combinations of therapies that could be contra-indicated," Michael R. Cohen, president of the institute for safe medication practices (ISMP) says. "And that's just not going to happen. Without the support of technology I don't think we're ever going to overcome this problem."