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EHR a Money-Loser for Most Physicians

John Commins, for HealthLeaders Media, March 5, 2013

"The other key finding is the value of the incentives looks really different depending upon whether you are a small or a large practice. These economies of scale go really far in large practices and in small practices they don't go very far," she says. "When you are in a one- or two-man shop it is hard to find the person who can step back and say ‘what do we need to do differently?'"

"The other big things in the small practices are the types of changes you need to make. A lot of them are around reducing staff. In these practices it is often someone's husband or wife who is the front desk person or they have a person who's been with the practice for 20 years. Just because you have EHR you are not going to cut their work hours by half or one-third because on a personal level it is so hard."

"I can understand why there was a one-size-fits-all incentive, but this data suggests that the economics of the EHR adoption look different in different practices. If I am a policy maker I am going to be concerned about the impact this is going to have on small practices."

Even though small practices face a significantly higher hurdle to successfully use EHR, Adler-Milstein says she still believes adoption is worth the hassles.

"We need to move to EHR forward for a number of reasons, but if I am a small practice I am going to really think about a few things," she says. "One is how to decrease the cost of adoption and the cost of the system itself. To the extent you can reduce the upfront cost that is going to help bring down the amount you have to figure out how to make up elsewhere. Increasingly there are new models taking this into account for small practices to decrease the big upfront costs."

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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.