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EHR All-Stars: How 3 Doctors Increased Profitability with Electronic Health Records


Healthcare’s digital revolution is in full swing. Patients want easy online access to their records, physicians want to run their practices with greater efficiency and the Department of Health and Human Services (HHS) is urging the meaningful use of electronic health records (EHRs).

EHR adoption rates have exceeded HHS goals, which is testament that the healthcare industry is finally starting to embrace new technology. As of April 2013, 291,000 physicians were using EHRs—a tremendous increase from 50,000 in January 2012.

But even with financial incentives, the dollar and time investment for implementing EHR systems can overwhelm smaller practices, whose resources are already spread thin. Fortunately, many physicians say the benefits significantly outweigh the cost and inconvenience of the change.

To find out how practices can use an EHR system to increase profitability, we spoke to three EHR “All-Stars.” These doctors reveal how their EHR systems contribute to lower operating costs and greater revenue in their practices, and share their tips on how you can achieve the same success.

Streamline Insurance Billing to Increase A/R Collection

Dr. Jill Squyres had always used electronic records in her psychotherapy practice, but not always successfully—her very first EHR was far from perfect. “It looked great in the demo, but the learning curve was steep and required a lot more training and expense than expected,” she says. “We made it work, but it became unreliable and costly to maintain over time.” 

The EHR technical support team suggested that Dr. Squyres switch from a Mac to a PC, which she did, but that didn’t resolve the system’s reliability issues. As maintenance costs climbed, Dr. Squyres shopped around for a better system.

The second time around, she investigated her options more thoroughly. Searching for the right EHR was time-intensive, but her diligence paid off when she found an EHR that fit most of her must-haves and was easy to use—so easy, in fact, that when Dr. Squyres relocated her practice from Texas to Colorado, she no longer needed part-time support staff to handle administrative tasks because she could complete them herself. The return on her investment at that point was significant.

For Dr. Squyres, the biggest time-saving feature of the system is insurance billing. She can invoice insurance companies with only a couple of clicks, and with invoice tracking tools, bills don’t get overlooked, so collection rates are approximately 20 percent higher than before she implemented the new system. The combination of lower operating costs and increased collections means Dr. Squyres now sees fewer clients and works fewer hours while maintaining the same income.

Dr. Squyres’ advice? Try the software before you commit to buying it. Don’t make a buying decision based on a walk-through that highlights only the best features. Do a trial run and enter real patient data into the system to test out how you would use insurance billing for collections every day. This will help you understand how big the learning curve will be and if the system is a good fit for your practice, which is critical for estimating long-term cost savings.

Use a Phased Approach to Slash Administrative Costs

Dr. Jennifer Brull is a leader in electronic record adoption and was the first physician in Kansas to attest to meaningful use. She shares office space with several physician colleagues, and together they made the decision to adopt a system they would all use in their respective practices.

After whittling a list of 200 potential EHR systems down to one, Dr. Brull and her colleagues to plan how they would make the transition. As a solo practitioner in a rural area, Dr. Brull couldn’t afford to decrease work volume or revenue during the switch, so she chose a phased approach to minimize a drop in efficiency.

First, a test database was set up on the server. Staff trained on the system over a few months and began scanning paper records into the electronic chart. Select staff received intensive training from the EHR vendor and became office “champions” who assisted other staff as needed.

Once everyone was familiar with the system, the EHR’s major features were scheduled to launch separately over the course of three months. Billing was launched first because it was the easiest change, followed by scheduling and finally charting. The phased approach smoothed the transition from paper to digital, allowed enough time for staff to learn the ins and outs of the new system and reduced the stress inherent with major process change.

Since implementing the EHR, efficiency has improved, the practice is more profitable and Dr. Brull has more than recouped her initial investment. According to a 2009 New York Times article, Dr. Dan Sanchez, who shares the EHR system with Dr. Brull, says costs have been cut by 75 percent. “That alone has paid for half the cost of the software in the first year,” says. Dr. Sanchez.

Dr. Brull’s advice? Use a phased approach that implements the easiest aspects of the EHR system first so operations are up and running on some level before you tackle the most difficult areas. Understand that everyone on your staff has a different comfort level when it comes to learning a new system, so encourage employees to reach out to “super users” who know what they’re doing and can provide assistance.

Dr. Brull also suggests consulting a Regional Extension Center (REC) in your area about creating a phased approach that’s right for your practice. RECs are resources designed to help healthcare providers through every step of the EHR adoption process, and the results speak for themselves: 85 percent of REC-enrolled providers are currently live on an EHR system, compared to just 62 percent of non-enrolled providers.

Green Up Office Operations to Save Dollars (and Trees!)

Dr. Michael Ciszek of Chicago’s Visionary Eye Care says his administrative staff “despised” him for six months as his practice transitioned from a paper-based records system to an EHR.

The exams portion of the system was fairly intuitive and easy to incorporate into their routine, but staff struggled to learn the billing and insurance features. The change was frustrating at times, but with training and support, they eventually mastered the system. In about six months, 100 percent of office operations were handled within the EHR.

Once the system was fully implemented, Dr. Ciszek says he immediately saw a return on his investment. The practice now runs smoothly—there are no more misplaced files, prescription errors or overlooked invoices.

Communication is also more effective. Reports sent to other physicians, once a tedious task that often involved deciphering hard-to-read handwriting, is now simple. Dr. Ciszek types a brief summary, attaches the necessary records and sends a digital report with a few clicks.

Since the switch, one of the biggest areas of savings has been paper supply costs, which Dr. Ciszek says alone is worth the cost of implementation. The paper-based records system he used previously produced at least five pieces of paper per patient per visit. Now almost zero paper is needed, saving over 1500 pages per week, and the little that is used is recycled.

The EHR has also helped Dr. Ciszek meet his green initiatives. The EHR was a principal component in helping Visionary Eye Care achieve Sustainable Business Certification, which underscores the practice’s commitment to sustainability and is a seal patients increasingly look for when deciding who to take their business to.

Dr. Ciszek’s advice? Provide support and training for your staff, and give them time to learn. There will be stress and hiccups along the way, and you may rely on a paper/digital hybrid for a while, but don’t let that dissuade you from adopting an EHR. The long-term cost savings and practice efficiency are worth it, especially when it comes to money saved from going paperless.

The benefits of successful EHR implementation are abundant. With an understanding of what your practice needs from an EHR, careful planning and training, your practice can join the list of EHR All-Stars, too. 

Be sure to check out the next post in this series, which discusses how 3 All-Stars are using EHRs to improve the quality of care they provide their patients.

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Janna Finch

About the Author

Janna Finch joined Software Advice in 2013 after 12 years of managing a boutique web development agency she founded with her husband. She attended the University of Colorado - Denver, and has a strong background in web usability, information architecture and translating techspeak into language everyone can understand.

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