EHR Systems: A Money-Loser For Most Physicians?
Adopting electronic health records appears to be a money-losing proposition for most physicians, especially specialists and those in smaller physician groups. The average physician would lose $43,743 over five years after adopting EHRs and only 27% of physicians would profit through the transition away from paper records without federal financial aid. And even when the $44,000 in meaningful use incentives are added to the pot, only 41% of physicians would be in the black, according to the study published this month in Health Affairs.
The study examined data gleaned from 49 community practices of varying sizes and specialties that were part of the Massachusetts eHealth Collaborative, an EHR pilot project. Meaningful use incentives were not in place for the period examined by the study. However, the study authors added the value of the meaningful use incentives on top of their initial projections...
...While she considers herself an advocate for EHR, Adler-Milstein says she is fearful that the findings in the study will be used by critics to call the movement a failure. "The real struggle we are in now is around how these systems were sold—as a magic wand and not as a tool," she says. "They are not a magic wand. You don't put them in and the next day you see higher-quality lower-cost care. The reality is there is a lot of hard work that has to go into seeing the benefits. In small practices they need help and support to do that hard work."...
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Open source vs. proprietary
Peter, I think the really big issue here is lousy proprietary software vs. open source. You don't hear this kind of complaining from open source EHR solutions. VistA is being implemented at 1/3 to 1/20th of the cost of lousy proprietary EHRs and due to its nature it can be customized to work the way physicians do. So that helps with the workflow.
Red Herrings
One thing we do know is that automating healthcare is 'not' a money losing proposition. When any major industry begins to adopt automated systems and transform itself you hear a rash of negative stories related to the cost, lack of benefits, implementation failures, systems not 'up to snuff', etc. The same things we heard when word processing first emerged, then PCs, then online banking, and on and on. It takes a while, but we all know that automation ultimately improves business processes, saves money over the long term, that numerous tangible and intangible benefits accumulate, and ultimately the concerns raised during the early stages of adoption fade over time. Check out Kaiser, VA Hospitals, Indian Health, and the many other healthcare systems that have been at it for over 10 years. They would never go back. They stayed with it and are reaping the benefits.