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April 25, 2011

Streamlining EMR Design for the real benefit of physicians

Abstract: Delivering effectiveness in your tasks through an EMR is quite challenging. Most of the EMR out there in the market focus on providing maximum number of features rather than the benefits actually gained by the users. Focusing on benefits first, Binary Spectrum provides an overview of the challenges in the EMR design and what can be done to overcome them.

Real requirements have constantly been ignored in an EMR design. Understanding the fact that physicians are performing their tasks under high time pressure and in a demanding environment, EMR is not just meant to boast about improved efficiency, more time for patient care or long term financial benefits. Instead it should focus on foremost points that are usually missed out like facing process challenges, having lesser customization instead of just providing customization facility, having straightforward tabs wherein minimal entry would populate the entire report or information.

Any challenges or complexities in EMR design can be overcome by considering simple basic requirements that are usually missed out in the haphazard of loading the system with extensive features. The following are some of the main requirements contributing to a successful EMR design:
·          It should be simple, straightforward with less complexity
·          It should bring in familiarity to avoid excess training
·          It should have consistency to help lower the learning curve
·          Should have appropriate fonts and size of content used
·          Appropriate colors should be used to convey precisely
·          It should be cognitive
·          Proper terminologies should describe the message
·          Instructions should be well handled
·          Should involve less documentation and data entry
The list can go on. However, all these drastically help the user to work lesser time in documenting in the system and spend more time in looking up patients for their care and safety. Any error made by users directly affects the potential safety of the patient. If attention is paid to these major requirements then the number of errors at present would reduce drastically. Patient safety would then effectively come into picture when physicians don’t forget a task or overlook some critical data or prescribe any wrong medication.  

In an EMR design, the user should not be led to waste time thinking and searching for tabs. Instead the design should provide transparency wherein it’s convenient and consistent for him to perform actions quickly in just a click. Overall, if physicians gain from using an effective system, the purpose of EMR is achieved.

Tangible and intangible ROI for an EMR and PM

Abstract: The pressure to invest in an EMR or PM for hospitals and clinics is large. However, on the other hand it has been proven that clinical applications like EMR and PM increases efficiency, improves quality of patient care and in a timely manner. The adoption of such healthcare applications conversely has been based on the fact if the healthcare providers would gain sufficient Return on Investment from the same or not. This article helps provide insights on tangible (monetary) and intangible (clinical) returns that are eventually gained from use of these applications.

Return on Investment conventionally is based on evaluating the impact of expenses with the revenues gained. When profits exceeded the costs involved, the investment was said to be justified and right. However, this may not necessary be the case with healthcare applications where the value of the investment could be more on intangible details like improved and detailed patient encounter, avoidance of medication errors, better quality care, etc.

The healthcare industry has still a lot to learn and progress on IT investments. It is essential to evaluate the application’s use based on the one using it more than the one providing it. Measuring financial returns is important but not the sole criteria for ROI. There are many qualitative returns too, especially in an industry like healthcare, that proves to be much beneficial than the financial figures. Various intangible benefits that results from adoption of an EMR are reliable quality of care, improved patient security, length of stay that is tremendously reduced and compliance to regulatory requirements. The most essential of all being reduction in medical errors that is the sole purpose of having investments in technology.

Measuring ROI and success of clinical systems like EMR or PM applications can be realized at a clinical and organizational level as well. Access to test results that are otherwise unavailable, quantifying costs per error, improving quality of care in an ambulatory care setting are some of the benefits at a clinical level. The operational efficiency of the organization too improves tremendously.

To evaluate the numerical metrics cash flow analysis, cost effectiveness analysis and total cost of ownership are considered. Main Tangible returns rendered are:

  • Improved revenue flows (Real case studies where adoption of EMR has given 300% ROI for the first year and payback period was just 4 months)
  • Compensation, grants and tax benefits from the government
  • Savings catering to labor, transcription
Delphi techniques and process metrics are helpful to identify the main intangible benefits. Some of the key intangible returns rendered are:
  • Avoidance of medical errors that has alarming effect on death rates
  • Increased patient time and patient satisfaction 
  • Increase the number and speed up the process of transactions
  • Improved ability and productivity of personnel
  • Secured and effective way of maintaining patient records
  • Increased information access
  • Adoption of EMR has proven to be beneficial in many ways and the ROI does not necessary dominate in the form of tangibles but intangible returns as well. Transformation in the delivery of health care, making it safer, more effectual, and well-organized has been the overall focus of these clinical applications such as EMR and PM.