The Truth About EMR – Physician Resistance

A reality of the health system in the United States is that it is behind almost all first world countries when it comes to the implementation and use of electronic medical records (EMR). The United States has a nearly 20-year deficit in technology automation compared to other types of customer-facing businesses. Other industries have spent billions on automation as they go about their business, while saving time and cost. In other words, it makes them more money! Where would the US healthcare system be today if our hospitals and private practices had kept pace with the average?

There is a long list of reasons why automation in healthcare has lagged behind other industries. However, before we start treating a multitude of symptoms, we need to look for the root cause. Physician resistance is the primary inhibitor of EMR adoption. Let’s explore some reasons for this resistance.

Resistance to change

EMR will completely change the way healthcare professionals conduct business. Documentation, prescription, references, billing; all these daily processes will change. Many clinicians, especially those who are not comfortable with technology, will have to step outside of their professional comfort zone to utilize the benefits of EMR. Physicians acting as practice owners have to spend significant amounts of time on research and education, both for themselves and for their employees, to ensure that the full benefits of EMR are realized. All of these changes and expenses can make practice owners very wary of EMR implementation. The baby boomer generation may be the most to blame for this. This generation of doctors, likely to retire in a few years, is reluctant to change their paper-based way of doing business, having been successful throughout their long careers. They may also be intimidated by the sheer amount of additional work that must be done to implement EMR.

Complexity

The complexity stems from the three main phases of EMR implementation: selection, project planning, and execution.

Selection: There are currently over 300 products on the EMR market. Choosing the best product for a medical practice is both an art and a science. No single EMR will be perfect; however, there are many that can fit well with any practice through customization. Professionals enter uncharted territory when it comes to software selection, which becomes the initial inhibitor to EMR adoption.

Project Planning: Depending on the size of the practice or hospital, EMR implementation may require professional consulting and project management. Rarely do clinicians or practice managers have the skills or staff to manage a large-scale implementation.

Execution: Preparing staff, adjusting workflow, and setting realistic goals is just as important as selecting the EMR itself. It doesn’t matter if the practice owner has found the perfect product, planning how it will be used hasn’t been fully explored. This lack of experience will lead to resistance from the doctor.

fear

Among the success stories boasting a 500% return on investment, there are EMR horror stories scattered throughout the healthcare community. I spoke to an orthopedic surgeon last month who “triggered” the same EMR, twice! Success and failure ultimately depend on the steps a medical practice will take to select and implement its EMR system. The fear of failure in making such a large investment is very real and is a justified inhibitor.

Weather

The bottom line; doctors are overwhelmed. They see patients all day and spend the afternoon finishing paperwork. Most doctors just don’t think they have the time to learn a whole new system and use it effectively and immediately. The reality is that most practices will see a loss of productivity three months after EMR implementation. But after this introductory period, not only will productivity increase rapidly, but processes will become more efficient, allowing employees and practice owners to better perform their roles. This will give more doctors the opportunity to provide a higher level of care, increasing their value to their patients and ultimately improving the bottom line.

Money

Cost can be an inhibitor to EMR adoption. For many small practices, implementing EMR can seem cost-prohibitive by traditional means. However, with so many different financing options, practices can find a way to pay for EMR if they are truly interested in improving their business and quality of care. One problem that needs to be overcome is the fact that many doctors do not see money as an inhibitor to adopting EMR, but instead use it as an excuse. The truth is, many professionals don’t want to go through the hassle of completely changing the way they do business. By ignoring the benefits of EMR, they are harming themselves, their company, their employees, and most of all, their patients. We’ll take a look at how to overcome this and other barriers next month.