overarching issues that must be addressed when implementing emrs in a small office setting

1. Overarching issues that must be addressed when implementing EMRs in a small office setting Barriers to Implementing EMRs Financial burden of implementing an expensive system; Interoperability, standardization and connectivity of associated clinical information systems; Redesign of workflow to facilitate the use of a health IT system; Technical support and training to help staff properly use the system; and Help with change management. Five major barriers preventing physician EMR adoption cost; complexity of the system; difficulty in choosing an EMR system; lack of staff to maintain information systems; and lack of system interoperability

3. Impact on Medical Practice while Implementation is going on. In order to address "pervasive anxiety and unhappiness" in the workplace, the physicians organized a weekly meeting for the full staff and another meeting for physicians. the initial stages of implementation had a negative impact on care quality and some patients left because of increased wait times disrupted workflow the quality of the office environment initially deteriorated greatly for staff, physicians and patients

4. The downside of electronic medical records A laptop computer that contains the health information of 1,764 patients of the CARES clinic in Sacramento, Calif., was stolen on Feb. 10, the Sacramento Bee reports. The computer's records contain the name, age, gender, race, ZIP code and HIV status of each patient but do not include addresses, Social Security numbers or driver's license numbers. "widening technology gap" between large physician networks that use electronic health records and smaller, independent practices that cannot afford to install them. it can cost $10,000 to $60,000 per physician and require extensive training and data entry. Technology can become obsolete and There is little benefit to EHRs because physician groups use different computer systems that cannot communicate with each other.

5. Future Needs need for additional funding to help small physician practices adopt EMRs At the end of the day, the reason to make this transition is its qualitatively better care. The goal is to make patients better, not to preserve the way of life of autonomous single physician practices

6. Perceived and Real Benefits of EMRs computer-generated prescriptions, faster access to specialist correspondence, real-time access to charts anywhere in the office, the ability to 'message' or 'route' information and tasks electronically in the office, the ability for the same 'chart' to appear on multiple 'desktops.'" They added that, within four to six months, wait times decreased for patients and staff members grew more excited about the benefits of the system over time would go back to paper health records helps us to better meet patient expectations expedites many tedious work processes "In about five seconds, I can transfer to my patient's hospital record and view the discharge summary from yesterday, the heart cath report from two days ago or the X-ray or lab results I requested earlier in the day. I can see the consultant's report and have all the pieces of information I need to effectively provide treatment to my patient,"

7. Financial Incentives Most EMR adoption incentives are pay-for-performance programs in which health plans and self-insured employers offer bonuses to physicians who meet clinical, patient satisfaction, administrative efficiency and information technology guidelines physicians will be more apt to participate in a pay-for-performance program and purchase the corresponding EMR if the bonus equals 10% of their annual salary or 10% of the revenue from a health plan February 15, 2006 survey (Oracle) About 67% of respondents said their organizations want direct government funding for EHRs, 58% said they want industry donations and 52% said they want tax incentives Oracle, along with Cisco and Intel, recently launched a pay-for-performance consortium to financially reward physicians who use technology to improve care for their employees and their families doctors who do not adopt EHRs will have difficulty competing under health insurers' pay-for-performance systems, which in some cases can increase a doctor's income by 3% to 4%.

8. Financial Incentives - continued The survey found that an integrated electronic records and practice management system cost an average of $7,232 per physician in 2004, while an individual records system cost $5,537 and an individual practice management system cost $4,189. Those annual expenses break down to monthly costs of $603, $461 and $349, respectively,

9. Bibliography and sources of information Implementing EMR in Small Office Setting , by Scott Weier, iHealthBeat editor August 12, 2005 http://www.ihealthbeat.org/index.cfm?Action=dspItem&itemID=113301 Financial Incentives Slow To Spur EMR Adoption iHealthBeat, December 09, 2004 http://www.ihealthbeat.org/index.cfm?action=dspItem&itemID=107893 Physician Groups Weigh Cost, Benefit of EHRs iHealthBeat, February 10, 2006 http://www.ihealthbeat.org/index.cfm?Action=dspItem&itemID=118662 Opinion: EHR System Improves Efficiency and Quality of Patient Care, iHealthbeat, January 05, 2006 http://www.ihealthbeat.org/index.cfm?Action=dspItem&itemID=117855