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EHR a Money-Loser for Most Physicians

John Commins, for HealthLeaders Media, March 5, 2013

Primary care practices with six or more physicians generally were more likely to see a profit with their EHRs than were smaller physician groups or specialists. This was more likely when the new technology was used to add more patients to the daily schedule and to improve billing processes so that accurate codes were used and fewer claims were rejected.

"It seemed like with primary care there was more opportunity to reduce costs," Adler-Milstein says. "There were more of them that saw savings in dictation compared with specialty practices. It may suggest that dictation is in wider use in primary care and there could be more potential savings in practices are able to eliminate dictation costs."

About 55% of the practices saw a reduction in the cost of paper medical records. However, nearly half of the practices saw no savings there because they continued to use paper records even after switching to EHR.  

"As we were in these practices collecting data, some said that for malpractice protection they perceived that they needed to keep paper-based documentation," Adler-Milstein says.

"Oftentimes they would create things in the electronic system but also print them out and store them. They were oftentimes documenting on paper or they weren't able to make the full switchover and become completely paperless. You say EHR and the assumption is paperless, but the reality is there are a lot of things that are still hard to do in EHR."

Adler-Milstein says the study suggests that federal meaningful use incentives alone are not adequate to ensure that the vast majority of practices don't lose money on EHR.

"You are going to have to make a lot of other changes to figure out how to realize cost savings. That is a clear message for practices: You have to figure out other opportunities to save money if you want to come out ahead," she says.

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5 comments on "EHR a Money-Loser for Most Physicians"


Dinesh Patel MD (3/8/2013 at 2:15 PM)
The basic benefit from EHR is health, welfare and safety of patients we love together with improved quality, reduction of redundancy and cost . This thought certainly is well known but in order to achieve there are many factors apart from EHR cost Participation of patients , infrastructure IT management and willingness of empowered people to listen from actual practitioners and keep the necessary element in meaningful use and not force folks such as-specialist to spend time in core and menu items [INVALID] may create error or omissions The thought that senior doctors can not type as good as young ones and that is an obstacle is myth. Who says they have to type They h ave to enter data EHR is wonderful tool and that will be quite a joy when you give visit summary report to patient end of visit and go over No better doctor patient relationships Do it as it s not EHR but it is the environment of providing art of healing to hurt from regulations ,consumers and politicians mistrust and compensation below the par looking at the life and death decisions health care providers make for the good of children's disabled elderly women and uninsured Sequestrations has been going on in health care and will continue so fight the challenge as health of the nation will improve by providing good care Best Debate and make impact Dinesh

civisisus (3/5/2013 at 11:14 AM)
substitute "office lighting", or "carpeting" or even "suture" or "tongue depressor" for "EHR", and the story reads the same. Grow some brain cells; In capable hands, EHR is a tool. In fact, unlike those other, humbler tools, EHR has the potential to be a more useful tool, the more that other physicians capably use it as well. That most physicians or physician groups do not yet have capable hands does not change that fact.

Tyco Brahe (3/5/2013 at 10:20 AM)
The US is very early in EHR adoption. It's premature to consider the steep learning curve as part of the reason EHR may make physicians lose money at first. Later, EHRs will allow physicians to code better and to help with malpractice claims. Overall, the entire health system will benefit because EHRs improve care coordination and prevent duplication. Certainly, however, physicians may lose money because they won't order tests and scans that another doctor ordered before them[INVALID]but you can't blame EHR for that. American healthcare has to move forward and not remain in the paper chart dark ages.