Purchasing an EMR

     So you have decided that it is time to purchase an EMR for your practice.  You are tired of the paper charting process and are ready to step into the 21st century, but what EMR do you buy?  So many practices are hurt financially and become frustrated from buying into the wrong type of equipment.  It is imperative that you take several factors into consideration before buying this costly piece of equipment, and find the system that is best for you.

     The first option you have is to hire a consulting firm to help you pick and set up the EMR. Consultants are well versed on all kinds of EMR equipment and can help you decide what type will help your practice the most.  More importantly than the guidance through the purchasing process, is the fact that many firms will help you set up the system and set it up correctly the first time.  With any technology, there will be bugs that need to be fixed and many consulting firms provide around the clock diagnostic service to help fix any problems that may arise with the software. The most important advantage of hiring a consulting firm to set up your EMR is the fact that they will teach you how to use the technology and get the largest benefit for your practice.

    Maybe you've decided that hiring a firm is ludicrous and you want to take on the task yourself.  If you decide to go this route, you have to first analyze what problems you want EMR to solve for you.  Do you want to cut down on the number of employees? Do you want to increase the productivity in your practice and eliminate the large volume of paperwork that you use? EMR can solve these problems but you must read unbiased reviews and do the research on each product to find the smartest option for the practice.

     You have to realize that buying an EMR is all about increasing your productivity which leads to increased profits for your practice.  Take this into account before purchasing your equipment because that swanky technology that one EMR might have may not help you accomplish your goals as well as a more basic and no-frills system will. The main idea in the article is "DO YOUR HOMEWORK", the same idea that carried you through medical school and got you to the position that you are in today.

 

Viewpoints about Doctors' Salaries

Really, how many porsches do you need?" has been a popular motto among proponents of Obamacare in response to objections by physicians at the possible pay cut brought on by the bill. This is a fair statement as most anyone would agree that if you are wanting to become rich, a medical profession is not the best option. However, physicians do have a reason to gripe in this case. After 4 years of med school and the loans that one can accrue over this period and the gigantic liability that a practicing physician faces, one would expect to be compensated at least enough to be able to pay off these fees once their residency is completed.

There have been many politically slanted opinions about the effect that Obamacare will have on doctors' salaries. Many in the medical profession are left wondering, "Will I be able to pay off my student loans?...Will I be seeing twice as many patients for half the amount of money and provide a lesser quality of care?" No one an really say for certain what will happen until the bill is fully implemented.

Many people fear that pay cuts will dissuade potential physicians from attending medical school and cause a great shortage of doctors in our nation. I think the best way for us to navigate this topic is to look at what the bill will do in theory to your salaries, without a political slant. First of all, it is important to understand what the goal of Obamacare is. It's goal is to lower costs of the American Healthcare system without lowering the quality of care. It resembles a European style of healthcare, and in this type of system, physicians make less money on average. In an issue of the journal, Health Affairs, the amount that French primary care physician makes was compared to what an American one makes.

PCP's in the United States on average netted around $186,000 while a comparable French doctor made $95,000. How will Obamacare affect the American pay? Well it is widely stated that the bill will cause physicians to be reimbursed at a lower than market rate for Medicaid. In other words, lower than what they are being paid now. This could spell doom for specialists such as general surgeons, who see many Medicaid patients for surgery.

With the lower pay an inevitability many believe that physicians will have to see a larger volume of patients to make the same amount of money that they do now. Many comment that this will cause a large decrease in care as doctors will rush to see as many patients as they can in a shift. We will continue to look at this issue in the coming weeks with more specific examples of how the ACA will affect you.

Health Insurance Exchanges

The Affordable Healthcare Act may have not only changed the United State's  healthcare system forever, it also may have changed the insurance industry  forever.  The implementation of so called health insurance exchanges, or HIX for short, have helped change the industry forever.  The model is a consumer based  approach, where customers will be able to shop for the best insurance plan for  them.  President Obama focused on allowing states to set up the exchanges  instead of a blanket approach that would make one exchange for the whole  country.

Ideally, the concept will allow people with preexisting conditions to be denied  insurance.  Customers will have to satisfy a smaller amount of conditions in order  to receive insurance.  Lawmakers envisioned this change as a system in which citizens will be allowed to have the same type of variety that members of  Congress have in shopping for their health insurance.  At this point you may be saying, "Great, now how in the world will they  implement this and what does this mean for me?" Let's try to answer this  question! The exchanges can cover a whole state or be broken up in to smaller exchanges in one state.  For instance a state like California may have a Southern  California exchange and Northern California exchange.  As long as the exchange covers a certain geographic area they will be allowed to operate.

States can also partner with other bordering states to create an exchange. As for how the exchanges will be run and affect you, the consumer, lets look at the car insurance model. President Obama has repeatedly compared these  exchanges to car insurance purchasing.  People living in an area that has a HIX  will be able to compare plans online and buy which ever one fits them the best.

There will different levels of coverage, given a gold, silver, or bronze designation. Only companies meeting the standards set forth by ACA regulations will be able  to sell their insurance plans.  According to www.obamacarefacts.com, this alone  will lower insurance premiums 7-10 percent. 

Listed below are the criteria to be  an ACA-approved insurance plan.

All plans must include:

1. Ambulatory patient services

2. Emergency services

3. Hospitalization

4. Maternity and newborn care

5. Mental health and substance use disorder services, including behavioral health treatment

6. Prescription drugs

7. Rehabilitative and rehabilitative services and devices

8. Laboratory services

9. Preventive and wellness services and chronic disease management

10. Pediatric services, including oral and vision care

We have yet to see if these will in fact work in the United States.  In theory,  they sound like a great idea and that they will allow for variety in insurance  shopping.  The hope is that more people will be able to become insured in the  long run.

Mobile healthcare

 

            If you have been in a doctor’s office lately you may have noticed your physician grasping an iPad or some other tablet.  What you have seen is a new trend in the medical field in which health care providers are incorporating technology into their practices. Along with electronic medical records, the practice of medicine, much like most things in our world, is going digital.

            The hope associated with this trend is the fact that medical practices can become more efficient and cost effective in the long run.  The days of paper charting may be a distant memory in the upcoming years.  According to a survey done by Manhattan Research in 2010, 72% of physicians responded saying that they use mobile devices in their practice.  The report also went on to say that the number will only rise in the future. 

In what capacity these physicians are using the devices in their practice is undetermined, but it is safe to say that technology companies have taken note of the possible new market that they can tap.  Companies such as Apple and Dell are currently in the process of developing mobile devices that are equipped with specialized EMR apps.  Many hospitals have already ordered these devices and are hoping that they will someday replace the infamously bulky and awkward computers on wheels. One hospital that has bought in to the technology is The Ottawa Hospital, which services over 1.5 million people in eastern Canada.  The hospital ordered 500 iPads specially tailored for EMR to a portion of its over 1,000 physicians recently.

            EMR is a new trend that has caught in many parts of the country.  Physicians can now chart physical exams and check patient histories and labs virtually instead of logging through stacks of paper. Though paper charting will probably never be extinct, the advantages of getting real time lab results and radiology right at a physician’s fingertips are astounding.

So how exactly will EMR and mobile devices change healthcare? The question is very broad and has many answers.  One answer is that of accessibility. On one iPad a physician can pull up a patient’s labs, radiology, and medical history without leaving the bedside.  This allows for a large cut down on the time it takes for a physician to give a diagnosis on a patient and places the patient’s information in one place.                        

                                              Photo Courtesy of www.macris .com

            From the information we can gather so far, it is safe to say that a majority of clinicians support using some sort of mobile device and EMR in their practice.  However, there are some limitations to relying totally on this technology in a practice.  Tablets are not the best tool for writing long summaries. In terms of sitting down and writing a long history on a patient or physician’s note, the classic PC is hard to beat.  Though there are some limitations to what tablets can help health care providers accomplish in a clinical settings, the pros definitely outweigh the cons.

            With the dawn of these types of technologies, the days when physicians view x-rays on through standard fluorescent light in a darkened dictation room may be few and far between. The prospects on the amount of time that can be saved from using mobile devices and EMR are very large.  As is the trend in the practice of medicine, the science is always evolving to fit the needs of the patients more efficiently and cost effectively.