A reality of the healthcare system in the United States is that it lags behind almost all first world countries when it comes to the implementation and use of electronic medical records (EMR). The United States has a nearly 20-year deficit in technology automation compared to other types of customer-driven businesses. Other industries have spent billions on automation as they go about their business, while saving time and costs. In other words, it makes them earn more money! Where would the US healthcare system be today if our hospitals and private practices had kept pace with the average?
There is a long list of reasons why automation in healthcare has lagged behind other industries. However, before we start treating a multitude of symptoms, we must look for the root cause. Physician resistance is the main inhibitor of EMR adoption. Let’s explore some reasons for this resistance.
Resistance to change
EMR will completely change the way healthcare professionals conduct their business. Documentation, prescription, references, billing; all these daily processes will change. Many clinicians, especially those who are uncomfortable with technology, will have to step outside of their professional comfort zone to utilize the benefits of EMR. Doctors who function as practice owners must spend a great deal of time researching and educating themselves and their employees to ensure that the full benefits of EMR are realized. All of these changes and expenses can make practice owners extremely cautious when implementing EMR. The baby boomer generation may be the most to blame for this. This generation of doctors, likely to retire in a few years, is reluctant to change their papery way of doing business as they have been successful throughout their long careers. They may also be intimidated by the large amount of additional work that must be done to implement EMR.
The complexity stems from the three main phases of EMR implementation: project selection, planning, and execution.
Selection: There are currently more than 300 products on the EMR market. Choosing the best product for a medical practice is both an art and a science. No EMR will be perfect; however, there are many that can be combined well with any practice through customization. Professionals enter uncharted territory when it comes to software selection, which becomes the initial inhibitor to EMR adoption.
Project Planning – Depending on the size of the practice or hospital, EMR implementation may require professional project management and consulting. Rarely do physicians or practice managers have the skills or staff to manage a large-scale implementation.
Execution – Preparing staff, fine-tuning workflow, and setting realistic goals is just as important as selecting the EMR itself. It does not matter if the practice owner has found the perfect product, if the planning of how it will be used has not been thoroughly explored. This lack of experience will lead to resistance from doctors.
Among the success stories that boast a 500% ROI are EMR horror stories scattered throughout the healthcare community. I spoke to an orthopedic surgeon last month who “fired” the same EMR, twice! Success and failure ultimately depend on the steps a medical practice will take to select and implement its EMR system. The fear of failure when making such a large investment is very real and is a justified inhibitor.
The bottom line; the doctors are overwhelmed. They come to patients all day and spend the afternoon finishing paperwork. Most doctors just don’t think they have the time to learn a completely new system and use it effectively and immediately. The reality is that most practices will see a three-month loss of productivity after implementing EMR. But after this introductory period, not only will productivity increase rapidly, but processes will become more efficient, allowing employees and practice owners to better perform their functions. This will give more physicians the opportunity to provide a higher level of care, increasing its value to their patients and ultimately improving the bottom line.
Cost can inhibit EMR adoption. For many small practices, implementing EMR can seem cost prohibitive by traditional means. However, with so many different financing options, practices can find a way to pay for EMRs if they are genuinely interested in improving their business and the quality of care. One problem that must be overcome is the fact that many doctors do not see money as an inhibitor to adopt EMR, but instead use it as an excuse. The truth is, many professionals don’t want to go through the hassle of completely changing the way they do business. By ignoring the benefits of EMR, they are hurting themselves, their business, their employees, and most of all, their patients. We will see how to overcome this and other barriers next month.