Most EMR and practice management vendors have focused on family or primary care, since they represent the largest percentage of the small to mid-size medical market. As a result, the unique needs of specialty practices have traditionally been underserved. While the broad-based solution providers focused on larger groups and hospitals, the EMR adoption rate amongst medical specialists has begun to increase due to the emergence of practice-specific technology.
Overcoming Barriers to Adoption
First generation EMR systems were designed for general practices and hospitals. In many ways, they represented a “one size fits all” approach. As more physician practices moved to their second generation EMR system, they began to advocate for more customized, flexible design and workflow. According to the KLAS report “Ambulatory EMR by Specialty Study 2012: Finding the Fit,” overall satisfaction rates for internal and family medicine were the highest but showed a marked decrease in scores for other types of practices.1 The report clearly indicates that more work needs to be done to address the functionality requirements of specialists. However, there are signs of significant progress both in terms of EMR adoption and satisfaction rates.
In a 2012 survey, Medscape asked more than 21,000 physicians from 25 specialties what they liked and disliked about their EMR systems and how the systems had affected their practices. “Eighty-two percent of survey respondents either currently use EMRs or are in the process of implementing them, up from just 38% in Medscape’s 2009 EMR survey – nearly two thirds (62%) of EMR users said that they’re happy with their systems – although many tempered their praise with descriptors such as “reasonably happy” or “happy for the most part.” 2
Factors driving adoption
One of the regulatory factors behind the growth of EMR purchases is the mandate around ICD-10. Specialty practices may have been reluctant to adopt EMR and practice management systems in the past, perhaps in part due to the lack of functionality to meet their workflow requirements. However, the move to ICD-10 codes in October of 2014 affects their ability to receive payments. This is a business driver for them to actively seek out an EMR that fully supports ICD-10. Software solutions providers who serve these markets understand that certain specialties may only utilize a few dozen ICD-10 codes during the course of an average day, and are able to offer EMRs that are fully compliant and “pre-configured” the systems with their most commonly used codes.
It is precisely this type of practice-specific customization that provides a clear business benefit in the form of more efficient, streamlined billing, which expedites the adoption of EMRs and increases satisfaction for specialty providers.
Another factor driving EMR adoption across the board, but particularly attractive to specialists who rely heavily on certain types of clinical images, is the availability of iPads as a platform for capturing, storing and retrieving patient photographs. The benefit of a mobile photo capture and retrieval feature allows doctors to increase quality of care through more detailed documentation and helps patients better understand their health issues by being able to view high-resolution photographs of their particular condition. From a business value perspective, “going mobile” helps specialty practices see more patients per day, increasing efficiency and revenue.
Unique Challenges, Unique Solutions
Most people would not immediately associate inventory management software with a specialty medical provider. Yet physicians such as ophthalmologists, dermatologists and plastic surgeons often sell practice-specific products in their offices as a way to increase revenue. Tracking the sales and managing these specialized items with an inventory module is another example of how software solutions have evolved to meet the unique needs of specialty providers. The emergence of these custom software modules helps drive EMR adoption because they maximize this important source of revenue in a business environment heavily impacted by lower reimbursement rates and increased operating costs.
The Future of Practice-Specific EMRs
Specialty practices must maintain regulatory compliance, operate in financially difficult market conditions and continuously strive to enhance quality of patient care. New, customizable software solutions allow them to meet these challenges while also providing highly efficient workflows that are designed for their widely varying and practice-specific needs. As the technology has evolved to meet their requirements, these providers are increasingly realizing the business benefits and clinical efficiencies that general practices have experienced. As a result, specialty practices are adopting and achieving the benefits of EMR and practice management systems at a rapid pace and this trend will continue to accelerate over time.
