Tuesday, June 17, 2008

EHRs for Non-Owned Clinicians - Loss of Productivity

As we implement EHRs for BIDPO practices, several clinicians have expressed concern about the loss of productivity during the first few months post go live.

What's been the experience for private clinicians implementing EHRs in Massachusetts thus far? The Massachusetts eHeath Collaborative implemented 600 clinicians over the past 3 years and generally found:

1. There was not a sustained drop in revenue. Indeed, clinicians had the opposite problem with most practices. MaeHC wanted practices to cut back on patient load during training and go-live, but most of them refused because they didn’t want a revenue reduction. On eClinicalWorks, most practices that did cut back were back at full-patient load within 2-4 weeks of go-live. MAeHC did have a few (literally 3 or 4 out of 150) practices who experienced a cash flow reduction because their clearinghouse transition went awry (generally due to the clearinghouse vendor). This usually took a short time to resolve and then they were quickly back to baseline.

2. During the first few months after go-live clinicians worked harder than before because they entered selected historical data into their EMRs for upcoming patients and sometimes staying later to get the same number of visits in as before. After 3-4 months clinicians started seeing some of the same patients cycle through, and that’s when they started to see the productivity benefits of an EHR.

3. The industry averages on productivity loss are for practices who did not have the type of preparation and end-to-end practice consulting that MAeHC and BIDMC invested in. For the BIDPO rollout, we are leveraging the practice transformation lessons learned from MAeHC. Based on the experience the MaeHC has had and the fact that we've assembled an implementation dream team of the same folks who implemented the 600 docs of MAeHC, we do not believe we will have a significant reduction in billing or productivity.

I'll summarize the impact when our data is in this Fall.

1 comment:

Ian Furst http://www.waittimes.blogspot.com said...

for what it's worth John when we swtiched to EMR (with schedule and patient tracking) our average daily revenue went up for the next 8 quarters. 18%, 18%, 11%, 5%, 8%, 3%, 6%, 6%. Better control of patient flow far outweighed productivity losses due to electronic charting. Also, within a year or two we'd learned most of the tricks. The only real time killer was login/logout in terminal sessions.