| Methodology | | | | underlying costs and benefits of EMRs. Responses to |
| Description of Research | | | | questions about the EMRs adoption cost and annual |
| The purpose of this study is to measure and identify | | | | maintenance fees revealed that 7 physicians (32%) |
| the major benefits and challenges of EMR | | | | do not know the upfront cost of software and |
| implementation. The objective of the study is to | | | | hardware installation as well as ongoing maintenance |
| describe the existing situation and experiences on the | | | | fees. This result indicated clearly that they have |
| implementation of EMRs across the country. This | | | | implemented EMRs through their large medical group |
| study has employed a significant qualitative approach. | | | | organizations that purchased IT for them. However, |
| It is based on collection of available data in regards to | | | | 32% of physicians reported that the average cost of |
| the implementation of EMRs and critical analysis based | | | | EMRs adoption is between $30,000 and $100,000 per |
| survey results from Family and other specialties | | | | physician and annual maintenance fees is between |
| physicians' perceptions. The method I used will be a | | | | $1,000 and $2,000 per physician. In addition, 6 |
| descriptive analysis of published literature and reports, | | | | physicians (27%) reported that EMRs adoption cost is |
| and critical analysis of conducting surveys. The | | | | below $30,000 per physician. Lastly, two physicians |
| research goal is to evaluate the transition from | | | | (9%) reported that EMRs cost is about $100,000 per |
| traditional medical records to a paperless system. It is | | | | physician with more sophisticated and complex |
| also to determine whether or not this rapid change | | | | features. Responses to questions about EMRs |
| will be co variable and potentially correlate with the | | | | benefits are illustrated in table 1. |
| impact of using EMRs versus HIPAA violations. | | | | Of the 22 who responded to the question whether |
| Selection of Participants | | | | EMRs improves their practice's productivity and |
| A total of 51 physicians from a variety of specialties | | | | efficiency, 95% of physicians reported, "Yes". Then, |
| within small and medium-size medical practices and | | | | they were asked to check benefits of EMRs aspect |
| varying locations in the Los Angeles and South Bay | | | | that apply to their practice. There is a significant |
| areas in Southern California were chosen to | | | | number of physicians who believed that electronic |
| participate in this mail survey. | | | | medical records have played a key factor in their |
| Instrumentation | | | | medical practices' productivity and efficiency as well |
| The effect of using EMRs and privacy concerns | | | | as the quality of care and patient safety and medical |
| perceived by physicians are measured through an | | | | reimbursement, such as: 1) saving their staff's time |
| administered questionnaire. The quantitative | | | | for looking and filing chart (96%), 2) saving office |
| measurement including the cost of implementing | | | | space for chart storage (91%), 3) increasing chart |
| EMRs have been assessed in this survey. In addition, | | | | documentation and accuracy for medical |
| the qualitative measures are used to assess the | | | | reimbursement 72%), 4) improving drug refill |
| physicians' perceptions on how EMRs would benefit | | | | capabilities (72%), 5) reducing medical errors (72%) |
| them, from improving the quality of care and medical | | | | as well as 6) improving clinical decision-making (72%). |
| errors to increasing health care efficiency while saving | | | | Also, when asking physicians about how much time it |
| costs, and their personal attitudes toward this IT | | | | will take them to look up or get a patient's health |
| network. | | | | record electronically within the same practice, 91% |
| Procedure | | | | reported that it takes less than 5 minutes and 10 |
| Fifty one EMRs physician users from different | | | | minutes from an external provider. |
| locations and medical practices in the South Bay of | | | | Responses to question about the EMRs challenge, a |
| California were randomly selected to participate in this | | | | significant number of physicians (45%) reported that |
| important survey. The assessment of their attitudes | | | | they have faced "none of these issues "with health |
| toward EMRs' adoption based on the result of the | | | | information technology. However, of the 22 who |
| questionnaire tends to be positive. Statistical analysis | | | | responded to the EMRs return on investment, 22% |
| is performed to correlate the implementation of | | | | of physicians reported that EMRs provides an |
| EMRs versus the number of HIPAA violations. This | | | | insufficient return investment. 4 % of physicians |
| allows me to examine the positive and negative | | | | reported that they have faced "all these above |
| impact of using EMRs in healthcare industry settings, | | | | issues" with EMRs (e.g. the figure above). |
| and to observe any correlation to the transition. | | | | Next, when questioning physicians about the impact |
| Measures of Questionnaire | | | | of EMRs on patient's privacy and confidentiality issues |
| The questionnaire consisted of 6 parts. The first | | | | using a 4- point Likert scale, 62% of responders still |
| section included questions about physician practice | | | | strongly feel that EMRs is secure and safe. |
| and ownership profile, the number of physicians in the | | | | Conclusions |
| practice, volume of patients in a typical day of | | | | The advantages of implementing of EMR system in |
| practice, number of employees and ownership type. | | | | physician practices settings are obvious, for patients |
| The second section contained questions about EMRs | | | | and health professionals. Ease of access to the health |
| adoption and type of EMRs using in their practice. | | | | information, increased safety and quality of care are |
| The third section included the cost and maintenance | | | | predominantly positive aspects of EMRs from the |
| fees of EMRs adoption. The fourth section-contained | | | | perspective of patient health as well as from |
| questions about the benefits of using EMRs in | | | | physicians' perceptions. With our modern electronic |
| physician practices included multiple-choice questions | | | | world in healthcare industry, health professionals and |
| to evaluate specific and potential aspects of EMRs. | | | | physicians will gain potentially from the possibility to |
| The fifth part was asked about the challenges or | | | | share patient's health information network within the |
| barriers of EMRs, which included multiple-choice | | | | same practice and among external providers. |
| questions. The last section contained questions about | | | | Elimination of duplication tests, monitoring chronic |
| patient privacy and confidentiality issues whether | | | | disease management or adverse drug interactions |
| EMRs is still secure and physician satisfaction related | | | | through EMRs enhancement will make the healthcare |
| to EMRs using a 4-point Likert scale ranging from | | | | delivery system more efficient and cost effective. As |
| "Strongly agree"(4), "Agree" (3), "Disagree"(2) and | | | | a result, the research studies and survey clearly |
| "Strongly disagree"(1), and similarly to "Very | | | | suggest and confirm that health professionals and |
| satisfied"(4), "Satisfied" (3), "Dissatisfied" (2) and | | | | physicians perceive that the EMRs are much better |
| "Very dissatisfied"(1). | | | | than paper records because it can enhance patient |
| Next, I was very interested in measuring the | | | | safety and care. |