Six Ways to Return On Investment

1. Spend less time documenting; see more patients without extending your work day!
What are the real time and money savings? Using topsChart and our patent pending FastForm to speed history gathering, real time savings can be achieved. The average time saved in documenting a patient visit with topsChart is 5 minutes. New innovations including 'Short-cuts' and FastForm make this possible. If you assume an average patient volume of 25 patients per day, then the math is as follows. Multiply 5 minutes saved by 25 patient visits/day, and you save 125 minutes/day (2 hours per day!) If you work 250 days per year, this equates to 521 hours or 13 (40-hour) weeks saved each year! If the 2 hours saved each day using topsChart to document visits is
converted into more visits, you could see an additional 6 to 7 patients per day. Before managed care became so intrusive, you could net approximately $200 per hour for your efforts. Even with managed care, you should be able to average $50 per patient visit. 6.5 patient visits/day by 250 days/year by $50/visit equals $81,250 per year in added revenue. In a fee for service environment, you should be able to do better than this. Alternatively, you can simply go home earlier every day and spend time with your family.

2. Improve your E&M coding!
e-MDs provides extensive documentation 'short-cuts' to speed the process of data collection. Collecting the complete review of systems, past medical history, and family and social history is rapid and thorough. Historically, most physicians tend to undercode, whether due to fear of an audit or to lack of time to sufficiently document the care given. A "level 2 E&M" visit is based more on deficiencies in documentation than on the merits of the visit. Electronic charting makes it possible to properly document your cognitive services in order to justify the correct E&M level. We conducted a study at Northwest Diagnostic Family Medical Center to study the effects of E&M coding support, recognizing the increased documentation efficiency afforded by an EMR. Northwest Diagnostic was able to increase average reimbursement by $9.01 per visit. Based on the assumption of 25 patient visits per day and a 250-day work year, this additional revenue amounts to $56,312 annually, per provider. The doctors in this study work 4 days per week and have a relatively comfortable patient volume of approximately 20 patients per day, so their actual increase in income was approximately $40,000 each. See the article on this site, "Are You Leaving Money on the Table?" published in Health Management Technology (March 2001) for more in-depth information.

3. Eliminate paper charts and their associated costs!
Northwest Diagnostic also eliminated paper charts by scanning all of their old records with our electronic document management product, e-MDs DocMan. Medical Economics (December 1997) has estimated that the creation, tracking, storage and maintenance of paper records cost $8 per record per year. With electronic records, there is no real estate wasted on chart stacks, and considerably less need for medical records personnel. The maintenance of an electronic record is estimated at $1-2/chart/year, netting a savings of $6/chart annually.

Assuming 3,000 active charts per physician, electronic records save $18,000 per doctor per year. Of course, in the first year of conversion, dual medical records will probably be maintained, so this savings will not be recognized for the first 12 to 18 months.

4. Eliminate dictation and the costs of transcription!
The average physician spends between $12,000 and $25,000 annually on transcription services. Even if you do not eliminate dictation, but just decrease it by 50%, you could save $6,000 to $12,500 per year. Depending on your set-up, the cost of leased hardware and an EMR, plus depreciation, might run you $1,000 per doctor per month. The transcription savings alone pays for the hardware and software!

5. Stop chasing paper!
When an insurance carrier denies payment for a service, your office staff has to track down the paper chart, find the relevant chart notes, copy them, and then attach the notes and resubmit the claim. With electronic document management, on the other hand, the appropriate record is effortlessly retrieved electronically and instantly resubmitted. The time savings are enormous. Multiply 20 to 30 minutes saved per day by 250 days in the year and you have captured an additional $1,500 per doctor on time savings alone. If some claims are simply not resubmitted because of the hassle (which happens more than you might think), you are missing out on thousands, or even tens of thousands of dollars in billings each year. Even better, an EMR using tools such as ICD-to-CPT links and CCI (Correct Coding Initiative) detection ensures submittal of "clean claims" the first time, dramatically reduces the number of rejected claims!

6. Automate charge capture
e-MDs is the only EMR today which can automate accurate charge capture. Our proprietary template 'extended attributes' make it possible to catch all valid charges relevant to a particular ICD-9. This process can be defined by a hospital or group administrator to occur automatically as the note is documented. Physicians have the ability to order 'unapproved' tests, but the tracking is in place to help them recognize when such charges may not be reimbursable. For the small practice, a physician can 'self-audit' their charges and see why insurance companies might be denying their charges. For the large, institutional practice administrator, this allows the organization to identify and capture the enormous number of charges that slip through every day and are never even billed. A hospital consulting group, Bryn Technologies audits hospital owned medical practices and has identified that the average "well managed" primary care practice loses over $250,000 in non-billed services per year. This averages between $75,000 to $100,000 in missed charges per doctor per year! topsChart does far more than electronic documentation. It stops the hemorrhage by identifying these charges during documentation, at the point of patient care. This is simply not possible with dictation, paper charts or the even most sophisticated billing system.

Other ways to save…
Ancillary benefits include lower malpractice risk and protection from embezzlement. Our topsBill practice management system has fraud and abuse prevention measures in compliance with HIPAA and a patent pending embezzlement safeguard built in to help ensure collection all copays and other monies owed to you. Considering as many as 50% of practices have some degree of pilfering, this can prevent thousands of dollars in lost funds and costly legal fees.

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So, What are the Final Numbers?

1. 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.

2. Correct E&M coding can add an additional $9 per visit on average (assuming results similar to Northwest Diagnostic's experience). Based on typical patient volume and workload, this gain is approximately $56,000 per doctor per year.

3. 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.

4. Eliminate transcription costs, estimated to save each doctor $18,000 annually.

5. Drastically reduce wasted time with denied claims, saving hundreds of hours per year for your staff. We estimate this to 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.

6. Automated charge capture 'discovers' lost charges. Conservatively, we estimate physician owned clinics lose $10,000 per year by this mechanism. Hospital owned clinics lose about $75,000 per doctor per year. We will assume $10,000 for the calculation. Add these numbers up. $81,000 + $56,000 + $18,000 + $18,000 + $1,500 + $10,000 equals $184,500 per physician per year, resulting from a combination of better billing and reduced costs. Even if a physician does not turn time savings into additional patient visits, he can still expect to net an additional $103,500 due to better coding and reduced overhead alone.

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How is this possible?

Technology really can introduce time management and other efficiencies into a medical practice. Not everyone will achieve these numbers. If you do not become a power user, availing yourself of all of the time saving features and charge capture tools included in topsChart, you can expect to enjoy a more modest increase in net income. At a minimum, physicians should reasonably be expected to achieve half these results. That is an additional $92,250 take-home income per year!

The cost of delay is significant. Each month that you procrastinate implementing electronic medical records costs you between $7,500 to $15,000 per physician in unrecognized income. Physicians who expend the effort to become power users, emphasizing training and implementation, will see their incomes increase proportionate to the effort.

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Non-Monetary Benefits

• Practice high quality patient care and demonstrate better outcomes with integrated evidence-based 'best practices' guidelines, automated drug allergy and interaction checking and included patient education handouts
• Decrease malpractice exposure with better documentation and built-in clinical decision support
• Have fun practicing medicine again! The charting experience with topsChart proves to be fun and refreshing, not a chore
• Eliminate repetitive manual tasks, such as post-it notes and chart pulls
• Reduce time wasted on the phone waiting for authorizations and checking eligibility
• Automatic superbill creation with correct ICD-9 and CPT pairings
• Automatically generated 'health cards' with problem list and current medications for your patients to carry in their wallet. ER physicians and patients alike appreciate the health summary
• Increased patient privacy over paper charts
• Immediate chart access anytime, anywhere
• Happier, less stressed clinical and billing staff
• Regained control of your practice, your patients, and your life
• And a bonus: 13 weeks of time gained per year to do with as you please. Avoid burnout with a mental health holiday or use the time savings generated with topsChart to see more patients and generate more net income.

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Barriers to EMR Implementation

CHANGE: "We are used to pulling paper charts and seeing patients a certain way. The staff isn't looking forward to change."

Change is scary. The good news is you don't have to do it all at once.

e-MDs has separate clinical, billing, and scanning modules, which can be implemented incrementally, decreasing the disruption in your practice and your staff. You might start with DocMan, our electronic document management system, and eliminate your paper charts. Or, implement electronic prescription writing to eliminate callbacks from the pharmacy. Unlike other single-solution vendors, when you are ready to add on charting, billing, scheduling, or scanning, we already have a solution ready to be plugged in.

The bottom line: the changes you make now will eliminate the aggravation and wasted time you currently spend managing paper charts in your practice.

TIME: "I'm too busy to take the time to learn how to use your software."

e-MDs software is physician designed. We pride ourselves on building intuitive, easy to use interfaces. The minimal time you and your staff spend learning to use the software will be compensated a thousand fold in time savings and increased productivity. In fact, most doctors can use our charting and documentation system after only a few hours of training! After a few weeks of use and experimentation, you will discover new features that multiply your efficiency and speed. Power users who avail themselves of all of topsChart and DocMan features will enjoy the full economic benefit of electronic records. You win financially and emotionally, your patient wins with better care and outcomes, and society wins with lower medical care costs through decreased hospitalization rates, reduction in iatrogenic complications, and avoidance of duplicate tests.

UNCERTAINTY: "How can I be sure I'm making the best choice? Are you going to be around in 5 years?"

Check us out. Compare our prices and features to anyone else. We are clearly the best value proposition over anyone in the industry. Our software is built on the latest technology and our development team adheres to ISO 9000.3 industry standards. We employ client server and n-tier architecture creating XML data output. Record-level security in DocMan meets HIPAA requirements. Still not sure? Read our physician testimonials. They speak for themselves. Who are we? e-MDs is the medical division of AMT Solutions, a leading software company with over 15 years of experience in loan and document management for banks. Some of the largest banks in the U.S. depend on our imaging systems to maintain their loan portfolios.

Banks don't take security lightly, and neither do we. Congress has legislated new patient privacy regulations known as HIPAA (Health Insurance Portability and Accountability Act), which become effective in the near future. Violations carry severe fines and even jail sentences in egregious instances. Compliance will be an enormous issue for legacy computer systems and traditional paper-based medical practices. Practically speaking, it will be impossible to comply with HIPAA using traditional paper charts. Our software conforms to the latest HIPAA mandates and its modular and flexible design permits easy adaptation to new mandates released by Congress.

COST: "I am working harder than ever and making less money each year. How can I possibly afford to buy computers and software for my practice?"

How can you afford not to implement electronic medical records? If you read this ROI analysis, the return on investment is clear. Quality doesn't cost, it pays. The system pays for itself in months. And as you become more and more proficient, the economic windfall only accelerates. A lease can be as little as $1,000 per doctor per month, while the return can be over $14,000 per month. The math is indisputable.

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The e-MDs Team

Our medical division is comprised of doctors, pharmacists, and nurses. We have over 30 contributing specialists to our clinical content. Our development team includes PhD level software engineers and database administrators. We are dedicated rofessionals on a mission to provide software that will change lives! In the coming decades, technology will result in a revolution in better patient care, better outcomes, lower costs, and higher physician satisfaction. We plan to be part of it. Join us!

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