| The adoption of an electronic medical record (EMR) | | | | and speaks to heart of the issue - the effectiveness |
| or electronic health record (EHR) in an ambulatory | | | | of the EMR in the delivery of clinical services with |
| care medical clinic is effectively a re-engineering of | | | | enhanced quality and enhanced efficiency. |
| clinical processes, in order to achieve (via digital | | | | More to the point: physician or ancillary providers are |
| information technology), enhanced quality and | | | | the largest line item cost in the clinic's income |
| efficiency in the delivery of medical services. | | | | statement. Should EMR software not enhance the |
| To achieve a return on investment, the adoption of | | | | quality and efficiency of the physician's function, the |
| such major organizational change must create a | | | | plan is a lost cause. It is for this reason that the |
| positive effect on the organization's income | | | | successful adoption of most EMR's is usually led by a |
| statement. The organizational leaders of the EMR | | | | physician "champion". Such a physician "champion" will |
| adoption must demonstrate that the initial capital | | | | no doubt be seeking an EMR which offers the |
| outlay (which may be financed over a reasonable | | | | artificial intelligence to enhance his/her own clinical |
| period of time), and, the ongoing maintenance costs | | | | acumen, while at the same time, facilitating the many |
| associated with EMR or EHR adoption, will bring | | | | tedious tasks associated with the documentation and |
| benefit to "the bottom line". | | | | implementation of the health care plan. No human |
| Most ambulatory care medical clinics already have a | | | | being free from error, however, the thoughtful |
| smaller network of computers in place used for | | | | physician "champion" will seek an EMR which may be |
| practice management software functions. EMR | | | | flexible enough to incorporate and remind him/her of |
| adoption will require extension of this network into all | | | | the changing standards of clinical care while |
| clinical exam rooms and all clinical stations. Thus, in | | | | conforming well to his style of practice. |
| addition to initial and maintenance EMR software | | | | The efficient EMR may accrue to the practice |
| costs, an analysis of the cost side of the | | | | savings in the realms of transcription costs, support |
| cost-benefit calculation must include an estimation of | | | | staff use and medical record supplies. Nevertheless, |
| anticipated initial and maintenance hardware costs, | | | | such savings must not be made at the expense of |
| and an estimate of the initial and maintenance | | | | physician dissatisfaction with clinical EMR function. In |
| network support (IT labor) costs. The organization | | | | most cases, the replacement of a dissatisfied but |
| may obtain a reasonably accurate estimate of such | | | | good and productive physician may be more costly |
| costs using the services of a reputable local network | | | | than his/her initial recruitment, orientation and training. |
| administrator, on a fee for service basis. Of course, | | | | Furthermore, the replacement of a failed EMR may |
| electronic medical record software (initial and | | | | well be more costly than its initial adoption costs. |
| maintenance) costs may be obtained directly from | | | | The selection of an EMR or EMR is a monumental |
| the EMR vendor. | | | | financial decision for the average ambulatory care |
| While the analysis of impact on the cost side of the | | | | medical clinic. At stake is the long term integrity of |
| income statement is relatively easily quantified, the | | | | the organization. Due diligence is mandatory. |
| analysis of the savings or benefit is rarely "clear cut" | | | | |