What's Motivating Your EMR Conversion Plan?
July 12, 2011
Motivated to improve patient care, meet compliance requirements and receive attractive federal incentives, hospitals and health care practices are scanning paper records in earnest. A new Iron Mountain survey provides valuable insights into how you can best implement your own EMR migration.
An 83-year-old woman with a history of dementia arrives at your office for a consultation. Cared for by harried nieces and nephews, she’s visited numerous doctors in the area and had many tests—yet no one can list all of the diagnostics administered. At one time, documenting her care in a single overstuffed paper file would have required a Herculean effort of both doctors and caretakers. However, after consulting the practice's new EMR system, the doctor now taking care of her can easily see that she's had an ultrasound, a colonoscopy and a bone scan all within the past three years.
Real-world scenarios like this one—in which a practitioner delivers a higher level of care—are why healthcare professionals are implementing EMR systems. In fact, the recently released Iron Mountain Study* establishes that 56 percent of the healthcare providers surveyed consider improved patient service as the primary reason for adopting an EMR system.
What's second? The regulatory environment is a motivator for 32 percent of the respondents. And it’s not hard to understand why. Hospitals and healthcare providers are under pressure to implement Electronic Medical Record (EMR) systems in accordance with the Centers for Medicaid & Medicare’s (CMS) Rules for Meaningful Use for EMR adoption, set forth in July 2010. What’s more, the “meaningful use” requirement offers these businesses a financial incentive—$19 billion allotted over five years, according to the American Medical Association—to make their total conversions by 2015.
Knowing this, many organizations working towards meaningful use compliance are developing strategies for measuring the “meaningful ways” their EMR systems comply with the rules. Here’s a framework for developing such metrics—and why partnering to achieve this goal may be wise.
EMR Faces Several Challenges
The Iron Mountain survey shows that only 38 percent of those responding have completed the process of scanning their paper records to convert them to an electronic format for ingestion into an EMR system. Almost one year after the meaningful use provision went into effect, however, 25 percent of those surveyed haven’t even started the scanning process. Furthermore, 35 percent believe physicians will use both paper and electronic records in their practices for the next two to five years; 11 percent envision that scenario for five years or more.
As healthcare professionals grapple with this transition, they face ongoing implementation hurdles:
What’s the “use?” CMS laid out clear incentives for complying with the meaningful use in three stages – by 2011, 2013 and 2015. Now with the clock ticking towards the deadline for 2011’s “Stage One,” providers are struggling to understand what this first stage means and how best to clear this first hurdle. What’s the true definition of that term? That’s generated quite a debate in healthcare circles, leaving room for interpretation.
Establishing meaningful measurements. Organizations such as the Healthcare Information Management Systems Society (HIMSS®) have issued recommended metrics of what constitutes an effective EMR conversion process. And interestingly enough, the Iron Mountain survey found that 44 percent of respondents are already measuring their scanning-program efficacy with quite explicit measurements. The lion’s share (65 percent) have set productivity targets, with quality-based objectives ranking second (46 percent). Other, less prevalent metrics include revenue management, revenue cycle improvement and budget goals.
Managing total costs. The EMR transition also comes with soft costs—the labor your facility must dedicate to the actual scanning process. The Iron Mountain survey reports that 72 percent of respondents are relying on in-house full-time employees to execute their conversion plans, but only 43 percent of the hospitals are using personnel with prior scanning experience. And even more revealing: Nine out of ten respondents hadn’t determined the per-image cost of scanning their records.
The Pay-off: Benefits
If you can navigate the challenges and transition to EMR, benefits abound. First there are the aforementioned government sponsored financial incentives. A Medicare provider could get as much $44,000 over four years; a hospital could gain a $2 million base payment in addition to a per-discharge fee (according to Medicare/Medicaid share) annually for up to four years.
However from a more operational perspective, an EMR environment offers these advantages over paper-based systems:
- Error reduction. You’ll minimize the medical errors that stem from incomplete or unreadable information in paper files that may be hard to find or access.
- Enhanced safety/security. It is far easier to protect electronic information from prying eyes, misuse and natural/manmade disasters.
- Optimal integration. Information moves seamlessly through EMR systems, affording doctors and their practices access regardless of location.
- Simply better patient care. With more complete and easily accessible (and shareable) information at their fingertips, providers can make better decisions and act quickly on the patient’s behalf.
Few healthcare facilities have the time, people and/or technology resources essential to tackle an EMR implementation—and why should they? After all, it’s not their core business. The Iron Mountain survey results concur: 55 percent of the respondents say they expect to outsource part of their EMR transition (scanning, storage or destruction of paper records) — an acknowledgement that this process might be done more efficiently using a partner.
An outside partner will help to negotiate the rigors of managing a hybrid records environment, since paper and digital documents have vastly different requirements in terms of safe storage and management. A partner also can integrate a Day-Forward strategy into your EMR workflow, scanning newly created documents right into the system. It can provide expertise to ensure your EMR system’s interoperability with other providers’ environments.
Third-party management of your records system also means you’ll stay on top of HIPAA and other regulatory demands. And going electronic means you’ll also have auditable proof of compliance.
Most significantly, a trusted partner can get you to a much better place in terms of patient care—and the caregivers of that 83-year-old dementia patient can rest assured she’s getting the best treatment possible. And when all is said and scanned, isn’t that the most important objective of all?
*Based on an April 2011 Iron Mountain Survey of 201 health information directors, managers and officers.
Iron Mountain Recommends
Consider these aspects of EMR implementation for a smooth transition within the CMS “meaningful use” guidelines:
- Build a strong relationship. Collaborating with a trusted partner takes the burden off of your internal staff, while tapping the benefit of expertise that’s too expensive to duplicate in-house.
- Consolidate your physical storage and scanning functions into a single operation while maintaining complete control and visibility.
- Convert your physical records on demand to scale back reliance on physical records, drive efficiency, and accelerate your EMR transition.
- Consolidate your patient information to a single format enabling your physicians to increase patient throughput.
- Maintain an end-to-end chain of custody throughout a record’s lifecycle.
- Implement retention and destruction schedules that meet regulations and your own requirements so you only store needed records.
- Verify vendor compliance to ensure that your medical records are handled properly. Doing so ensures that you satisfy both meaningful use and HIPAA regulatory requirements.
Do you have more questions about your EMR transition options? Read additional Knowledge Center stories on this subject, or Contact Iron Mountain’s consulting services team. You’ll be connected with a knowledgeable product and services specialist who can address your information management challenges.