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Five years after adopting an electronic health record (EHR) system, a North Carolina ophthalmology practice saw a 41% return on investment, and netted roughly $1.2 million in revenue, according to a new report.
Asheville, NC-Five years after adopting an electronic health record (EHR) system, a North Carolina ophthalmology practice saw a 41% return on investment, and netted roughly $1.2 million in revenue, according to a new report.
“(The success) was a combination of more efficient uses of resources and eventually in productivity gains,” said Robert Wiggins, MD, of Asheville Eye Associates, NC, and lead author of the report.
While the 13-provider practice switched to an EHR in 2006, costs initially increased due to the hiring of IT staff, software maintenance, and scanning paper records, stated the report, which was published in Ophthalmology, the journal of the American Academy of Ophthalmology.
Asheville Eye Associates were able to pay off its initial investment in hardware and software, amounting to $500,250, in less than 3 years, according to the study.
The report went on to state that process changes driven by the EHR eventually led to efficiencies, which lowered staffing needs related to medical records, transcription, billing, check-out, and appointment schedule.
Furthermore, the system acted as an earnings driver by enabling EHR Meaningful Use incentive payments, which increased productivity in the later stages, which made claims submission faster and more accurate.
The ability of the physicians to send prescriptions electronically to the optical department produced incremental optical revenues as well, ranging from $216,000 to $385,000 per year.
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“We had been looking at EHR adoption for a number of years prior to adoption,” said Dr. Wiggins. “By 2006, we felt the EHR systems had come along far enough in terms of functionality that we could introduce it into the practice and realize the benefits of EHR in terms of efficiencies in managing medical records (vital in a large practice with multiple offices) and access to the data for measuring quality.”
The physicians' productivity dipped a tad in the year the EHR was introduced, because seven of the providers cut back their schedules during the first month after implementation. After that, the average productivity of the clinic remained constant for 3 years. But in the 5th year, three full-time-equivalent providers increased their productivity by slightly expanding their schedules, which resulted in 1.23 more patients being seen daily across the clinic.
The providers' ability to see additional patients increased overall clinical revenues by more than $800,000 that year.
According to a March survey-conducted by Mathematica Policy Research and published in Annals of Internal Medicine- while EHR use has steadily increased among office-based physicians since the passage of the Health Information Technology for Economic and Clinical Health Act, the number of physicians who do not or do not plan to participate is substantial.
The survey included 3,437 physicians, mostly in primary care. In 2011, 44% of those polled had an EHR system that met basic criteria, with another 19% adopting basic EHR systems between 2011 and 2013.
By 2013, 20% more were in process of implementation, and another 8% planned implementation within the next 2 years, according to the report. Nine percent- which consisted mostly of older physicians and those most likely to work in independent or solo practices-had no plans to adopt an EHR system.
Most non-adopters also used fee-for-service as their primary compensation and were less likely to participate in incentives focused on continuity and quality of care, or chronic and complex patient management.
Unlike many of his medical colleagues, Dr. Wiggins said he has viewed EHR adoption relatively positively since their inception.
“My feelings about EHR have been positive from early on,” he said. “It is nice to see profitability with any capital investment.
“The qualitative benefits of having an EHR have been important as well,” Dr. Wiggins added. “It is much easier to access records and data, and participate in quality improvement programs.”
Because of his mindset, Dr. Wiggins said he has not found the success of his EHR adoption particularly shocking.
“I was not surprised at the potential positive financial return since we knew that we had a lot of inefficiencies in managing paper records,” he explained. “That is the advantage of developing a pro forma analysis.
“We are one large practice with multiple offices, so our results aren’t necessarily going to be the same for every practice,” he added. “However, regardless of the type of practice you have, physician and staff engagement and training are very important to making EHR implementation a success. That said, all practices can use EHR implementation as an opportunity to focus on workflow changes that can benefit their practices.”