In this final installment on understanding how EMR/EHR legislation impacts you and your private practice, we will discuss what you need to know about as you consider adopting an EMR or EHR system. So far, in this series, we have discussed the topics below. We’ve linked to the articles in case you are interested in reading those as well:
- In Part I we introduced the differences between EMR and EHR systems, and provided links to additional resources to learn about EMR/EHR and common definitions you may encounter.
- In Part II we reviewed the development of EMR/EHR legislation, and discussed its specific impact on your behavioral health private practice.
- In Part III we outlined the clear benefits of adopting an EMR/EHR system if you are in private practice in the mental or behavioral health field.
Below, in Part IV, we will outline the barriers to adopting an EMR, benefits, and considerations as you make a decision regarding an EMR system.
Barriers to Adopting an EMR
The Initial or Ongoing Cost
First and foremost, cost is the most significant barrier to adopting an EMR for most mental health and medical professionals. Some EMR systems can be quite expensive, but surprisingly, EMR systems in the behavioral and mental health field can be quite affordable. Regardless of cost, most clinicians see any cost of adoption as a barrier to implementing and adopting an EMR system with an ongoing cost.
The Transition to Electronic Records
Additionally, the transition from paper files to electronic files can be a significant deterrent or at least a barrier. Especially in group practices where some may be resistant to change, the initial transition to electronic medical records can be a daunting ordeal. To be honest, switching to electronic medical files is a comprehensive task that takes some time. Beyond choosing the EMR, there is training involved for the whole staff and reworking your organizational systems. In some cases, purchasing technology may be required, such as add-on systems for the EMR or even tablets and PC’s.
Uncertainties You May Face
A lack of clarity certainly is viewed asa barrier to adopting an EMR. The legislation that governs EMR/EHR systems is complicated and convoluted, and there isn’t one specific place to find your answers. As you consider adopting an EMR for your practice, it is imperative to understand exactly what you’re investing in, and when the information is complicated and difficult to collect, that leads to uncertainty. Uncertainty in policies, procedures, expectations, legislation, interconnectivity, privacy, security, and more lead to barriers in adoption.
A lack of Incentive
Finally, a lack of incentive is clearly a barrier to adopting an EMR. The government has implemented an incentive program to encourage clinicians and medical professionals to become early adopters of EMR systems, as this is the direction the legislation will increasingly lean towards. However, in nearly all cases, behavioral and mental health professionals do not qualify for these incentive programs, and so, on its face, there appears to be little incentive for behavioral health clinicians to adopt an EMR early.
Considerations When Choosing An EMR
We have previously discussed the benefits of adopting an EMR in part three of this series, and we firmly believe that the benefits outweigh the barriers. In part, it is because an EMR does not have to be exorbitantly expensive and it can actually save your practice money, even in the short term, while also improving the quality of care and accessibility within your practice.
However, as you conduct research to adopt an EMR for your practice, regardless of its size, there are several important considerations to keep in mind.
Consider Your Goals and the ROI
- Understand how the EMR you are considering will accomplish the key goals of your practice. Ask for a demo and test-drive your specific needs with the EMR you are considering. As you observe the demo or test the system, use common scenarios that may come up in your office or client interactions to be sure that the EMR will meet your needs.
- Compare and evaluate the advanced features of the EMR. An EMR system isn’t simply an electronic database of client files; it can include payment systems, HR modules, document servers, and more. Evaluate your practice’s needs.
- ROI is a marketing and advertisement term that refers to your “return on investment.” For example, if an ad costs you $25,000 to run, and you have gained an additional $,1000 in revenue, your ROI is terrible; the advertisement wasn’t worth the investment. As you research EMR companies and you consider your goals, evaluate whether or not the EMR gives you a good return on your investment; do the features make your life easier, help your practice be more efficient, even save you money?
Consider The Technology of the EMR
- Security and Privacy is a significant concern and should be your EMR’s highest priority. Be sure to ask about HIPAA compliance, encryption, and data storage for the EMR you are considering. Data should be stored remotely, backed up frequently (multiple times daily), and all information should be transmitted in encrypted fashion.
- An important component of selecting the appropriate EMR for your practice is to evaluate the specificity of your EMR for your industry. You should choose an EMR that will make your life easier, not more complicated. An EMR system should be easy to implement and should be designed specifically for the mental health industry so it is optimized to function for your needs. What you do not need is an EMR designed for doctor’s practices and has been modified for use in behavioral health.
- Certification is also an important factor in choosing an EMR. The process of moving the entire healthcare industry of the US into implementing and utilizing electronic health records, and then certifying the companies helping your accomplish that is a daunting task, and will take a considerable amount of time and investment. You should consider companies who are certified, qualified, or who are in the process with the ONC towards certification.
Consider the Ease of Access
- The transition to electronic files is a complicated process as all client information is entered digitally. It is wise to understand and clarify roles, responsibilities, and costs for data migration.
- Integration and data migration is another important aspect; what will happen to your data if you need to move to a different provider. You should consider asking the EMR provider how to access your data or migrate it to a different provider.
- Ease of Use and Functionality. EMR’s have the potential to significantly reduce time spent on filing and organization. Any EMR will have a learning curve, but consider how the EMR works, its functionality: does the EMR help you solve problems, does it make your life easier?
- Finally, gauge the company’s customer service and dedication to helping customers be successful. Read about the company’s mission statements, company values, and their vision. If possible, read reviews and testimonials on their software and products or services.
Consider the Financial Commitment
- Clarify the pricing structure and all the costs involved in the EMR you are considering. Some EMR systems may require computer upgrades, hardware and software downloads, licensing fees, implementation costs, initial set-up and training costs, and per-user fees. Additionally, you should be aware of fees for ongoing training, technical support, and maintenance fees for the software you are purchasing.
- Be sure to understand the set-up, implementation, training, and technical support you will receive as you consider committing to an EMR/EHR vendor.
As you make your decisions on adopting an EMR, be sure to understand your own practice’s workflow, your needs and practice’s areas for improvements, and what you want to have your EMR accomplish. Then research EMR companies that can help you accomplish those goals.
