Practice Management Alert

As your practice gauges the cost of converting from paper to an electronic medical records (EMR) system, make sure you include these hidden expenses. Beyond the initial cost of the software, experts point out several other ways the bill can add up. Potential costs could offset the benefits of EMR that were discussed in last month's Medical Office Billing and Collection Alert. Your practice should consider these costs when determining the feasibility of conversion. Equipment expenses. Most practices need to purchase both software and hardware when they convert to a paperless system, says Jim Collins, CHCC, CPC, president of consulting firm Compliant MD and compliance officer for a cardiology practice in Matthews, N.C. For an EMR to be effective, all clinicians will need access to workstations regularly, throughout the day. "As soon as you get an electronic system, the next thing that the doctors are going to want is some sort of hand-held device so that they're not bound to a desktop station or even a laptop to enter their notes," Collins says. Training. Beyond the equipment, you're facing the intangible expense of training everyone and of changing the way your practice handles its daily routine. The easier a system is to use, the less time you'll spend training. Find out how much support your vendor offers: Does the vendor provide training? Does the company offer support staff to answer questions? How accessible is support? Maintenance. It's important to know what kind of service the vendor will provide, says Jill Burrington-Brown, MS, RHIA, professional practice manager with the American Health Information Management Association in Chicago. Once your practice has made the switch to EMR, you can't afford to have the system go down for very long, she explains. That means a vendor needs to offer round-the-clock service that's guaranteed to be on-site if needed. Integration. It's important to get a system that works effectively with your practice management system and delivers the kinds of billing improvements you expect. Integrating with other systems may add to the expense, but it will also increase the effectiveness of your EMR. Consider integrating with lab and pharmacy systems that you now use, Burrington-Brown says.

EMRs aren't cheap to start with  one large physician practice in California learned an EMR might cost them nearly $10 million, the Silicon Valley/San Jose Business Journal reports. The California practice decided they couldn't afford that price, but they didn't want to do without an EMR, either. So, they hired people to custom-build an EMR and spent only $500,000, according to the business paper.

If the do-it-yourself method doesn't sound appealing, don't worry. There are hundreds of EMRs available, and most practices can find one to fit their needs [...]