Billability slowing EMR progress

Why don't more doctors use Electronic Medical Records? It may be because EMRs record every mistake, and let insurance companies refuse to pay you.

Certainly there is still enormous resistance to EMRs, and lots of reasons for the resistance:

• A recent study at Stanford and Harvard showed no improvement in patient outcomes where EMRs were used.
• Many doctors are finding they don't save money with EMR. It actually costs them more.

But I really think it's the payment point, made by JD Wolverton in a recent post to the DailyKos Web site, which may be most important. (Wolverton identifies himself as being in favor of EMRs.)

As SRSSoft CEO Evan Steele wrote recently, "Highly compensated corporate executives earning as much as $250,000 or more are not taking on the tasks of data entry." And they're surely not happy about taking pay cuts for it:

Evidence from exhaustive research concludes that manual data entry of patient exams slows the doctor down by up to 15%, equating to an approximate 30% decrease in take-home pay for the physician, according to a 2005 benchmark survey of 3,300 practices conducted by the Medical Group Management Association in collaboration with the University of Minnesota and funded by HHS.

Or, as Wolverton notes:

Although we teach all HIM professionals to cross out mistakes with a single line, then add the correction. In practice, the incorrect chart record is usually rewritten correctly and the offending sheet is confetti shreaded (this is against regulations, but done anyway). An electronic medical record would have these mistakes saved along with the correction, so you can see where's some resistance is coming from.

Again, Wolverton supports EMRs. He calls the EMR debate a "distraction" created by opponents of a universal health care system. But "We need it and can't afford it at the same time."

If insurers accepted changed EMR records and paid you for your time, would you implement the technology? What if you could implement EMRs at no net cost?