HIMSS: Small practices should take time to educate staff for EMR rollout
ATLANTA–In the implementation process of an EMR, time needs to be allotted in the rollout process to educate the staff about the new system, according to Stanley Wisniewski, MD, principal at Cal Arundel Family Medicine in Huntington, Md., during an educational session Wednesday at HIMSS10.

Wisniewski set out to explore the challenges, benefits and ramifications of the American Recovery and Reinvestment Act’s (ARRA) incentives for EMR adoption by solo private practices and how starting early leads to financial gain.

There are primary concerns for solo practitioners that organizations need to prove meaningful use by an EMR with e-prescribing and connectivity to other physicians to improve access to a patient’s health history along with the ability to report on the use of technology, said Wisniewski.

“The ramification of not adopting the EMR system is lost revenue," he said. "Despite costs, now is the perfect time for physician practices of all sizes to adopt a certified EHR to gain the maximum benefits and rewards from Medicare and Medicaid.”

Organizations should want their EMR system going live before 2011 to begin gaining financial reimbursements, according to Wisniewski. For Medicare incentives, $18,000 is available for reimbursements in 2011 assuming the organization bills $24,000.

Up to 2015, Wisniewski said that the subsequently available reimbursements would be:
  • 2012: $12,000;
  • 2013: $8,000;
  • 2014: $4,000; and
  • 2015: $2,000.

After 2015, practices will begin to be penalized, according to Wisniewski. "If an organization begins receiving reimbursements later than 2011, that’s lost revenue that the organization could have gained," he said.

According to Wisniewski, your vendor should also be able to support your needs and the organization should ask the question “Does your vendor listen to what you have to say and does your vendor create a system beneficial to you?” It took Wisniewski six months to decide upon his EMR vendor between six vendors. “Play with the product and see what’s best for you,” stated Wisniewski.

It took six weeks to implement the system but using it was still somewhat slow for about two months and his organization had to reduce patient load by 50 percent in the first two weeks, according to Wisniewski.

According to Wisniewski, a step-wise implementation process is best as EMR systems need clinician buy-in to become successful and, therefore, should be integrated slowly.

At his own practice, Wisniewski noticed a 1-3 percent increase in reimbursements over the three year period as a result of e-prescribing for three years, as well as an additional 2 percent as a result of automatically tracking and reporting measurers in compliance with the Physician Quality Reporting Initiative.

Additionally, charge capture at the time of the billing process is helpful in that it communicates with insurance companies for real-time adjudication of companies, Wisniewski stated. Tracking who owes what assists in some financial gains, he said.

As advice, Wisniewski note that “most of the coding software associated with EMRs is on the reserved side so individuals should know how to code themselves.”