EMR: Do You Feel A Chill?

I'm not going to expound very much on this N&R article by Lex Alexander about physician practices making the switch to EMR (Electronic Medical Records). He covers all the bases (cost vs. benefit) save one . . . and it's one I briefly alluded to in my recent post on "The Death of Pediatrics".

Lex focuses on the biggest problem I've seen with EMR - over and over again during my travels. The start-up with EMR . . . or the switch of an established practice to EMR . . . is massively expensive . . . many smaller/private practices simply cannot afford/absorb it (for instance I don't know any solo Pediatricians with $30-40,000 just lying around). Moreover, if the switch is made, the learning curve can play hell with physician productivity for a very, very long time.

In the short-term, from a physician's vantage point, EMR pretty much sucks.

But Lex misses one long-term benefit. Hospitals and big groups these days operate in a very cut-throat fashion . . . and "good will" in a buy-out means next-to-nothing. Physicians who have worked for years . . . pouring blood, sweat and tears into practices (on the premise the successful practice/business they built would be worth something when they were ready to retire) . . . have found that out the hard way when the time came to sell.

But once the switch to EMR is made, the physician has a much better bargaining chip . . . if he/she ever wants to sell . . . than he/she would have with room full of paper charts that the buyer will almost certainly have to scan/convert.

The patient data all neatly recorded on computer hard-drive or disk is worth something . . . and can go to the highest bidder (perhaps recouping at least a portion of the investment - if not all of it). I suspect many primary-care doctors . . . on the wrong end of reimbursement cuts for well over a decade (i.e., the "flat" rates and increased operating costs that the doctors interviewed for Lex's article talked about) . . . and/or those doctors burned/screwed at buy-out when it came time to retire . . . will find some small satisfaction in that.

Revenge is a dish best served cold.