The EMR Conundrum

I was at my Primary Care Physician’s office recently for a sinus issue. What used to take 5 minutes, took over 20 minutes as the Doctor was pointing and clicking on the computer. Finally, I said to him, “How’s this EMR working for you?”. His response was, “Primary Care Doctors who have been using EMRs for 2 to 3 years are seeing a third less patients”. Wow, a third less patients – I wonder what that does to the practice revenue stream?

If you are like most practices, you have made dramatic changes to comply with the Government’s EMR requirements. Whether your doctors have transitioned to using templates, or speech recognition or medical scribes or you have brought transcription in-house, you should have some empirical sense of the impact the EMR has had on both your practice’s cost structure and revenue.

Dictation is a productivity tool that allows the Doctors to leverage their revenue opportunity against the much lower costs of transcription.

Some Medical Practices are embracing speech recognition and templates within EMRs as they see it as a way to eliminating transcription costs without regard to the Physician’s productivity and associated revenue stream. There remains significant productivity and positive revenue benefits for the Doctors to dictate using transcription over Dragon speech recognition. With speech recognition, the Doctors need to slow down their speech delivery and then edit the dictation for accuracy. With templates, the Doctor is performing clerical point and click functions which are equally time consuming and unproductive. The time it takes to do these functions adds up and typically the Physician would be able to see several more patients in the course of a day. If they are able to see 1 more patient, it would be a break even proposition (or positive revenue gain) against the cost of transcription.

Medical Scribes is essentially having a personal secretary shadow a Physician which amounts to 2 to 3 times the cost of transcription.

In-house transcription typically costs 15 – 18¢ per line for part time transcriptionists and 18 – 30¢ per line for full time transcriptionists (with benefits) versus outsourcing costs of 10.5 – 11.5¢ per line.

We have seen a rebound effect with Doctors who have left us to use the prevailing options with EMRs have returned to dictating to us because of the productivity and cost issues.

It is time to rethink the accommodations that your practice has made to adapt to EMRs and reconsider what is best for your practice from a cost and revenue perspective.

Through a remote desktop application, we can type directly into your EMR with Dictation Markers. We can return the transcription following unique file naming protocol to facilitate import through an interface into your EMR.

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All of our work is done in the Continental United States. We have nurses proofread the work to ensure high accuracy. We will customize our work to meet your unique needs.

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