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Basics of EMR Costs

You’re looking at an EMR system. You know that licenses and support aren’t free. What will you have to buy? Vendors usually base their EMR licenses on the number of providers and the number of work stations in an office or clinic. Here are the basics:

You’ll usually have to pay someone to plan your system and train your staff on how to use it.

Hardware Costs for EMR

You propose to have your EMR stored in computers in your practice. What will you have to buy? For starters, you’ll need personal computers for all your offices and exam rooms. Add to that network hardware, central database servers, and, if you have remote office, possibly communication servers.

You'll need desktop PCs for each doctor, nurse, and your front desk. You’ll want desktop or notebook PCs for each exam room. You’ll have to hardwire these computers into an office server or set up a wireless network. You may also need tablet or handheld PCs.

Is there a way out of all that expense? Yes. You can avoid large up-front costs with a subscription-based system delivered over the internet.

Highest EMR Codes for Big Savings

One of the main ways physicians lose money is because they don’t know the proper code. They’re afraid of being audited so they list the lower code, not the higher one that they might be entitled if they had the time to document it. A good EMR will quickly document the highest permissible code. Medical Economics magazine estimated that physicians who routinely down coded one E&M level lost from $40,000 to $50,000 a year.

Even more stunning is the savings to be made by maintaining an electronic chart. Medical Economics reported in 1997 that it cost about eight dollars to create, track, store, and maintain a paper record. The cost for an electronic chart? Two bucks a year. How much you save depends on the number of charts you process. And since EMR takes up less space, you don’t have to lease or buy a larger office or clinic.

Calculating Savings with EMR

So okay, all these vendors are telling you how much money you’re supposed to save with EMR. It all sounds wonderful but how, exactly, do you calculate your savings?

Vendors who calculates savings usually do it in such a way as to make their software look good. They also use different methods of calculation. Hard to pin specific numbers.

One "estimate" is that a good electronic chart will save you about five minutes for each visit. Why is that? Most patients of a given specialty have the same complaints that use similar findings and plans . Therefore a physician can use a structured template containing their most common observations. Followup visits can also use information from prior encounters to more quickly document the visit.

An average physician sees about twenty-five patients each day. A savings of five minutes for each patient means you can see seven or more patients per day. Before managed care, you could make a couple of hundred bucks for each patient. Now you’ll make maybe fifty. Seven times fifty equals $350. Put another way, if you were able to see an extra 6.5 patients per day on average that means 1,560 patients a year for an additional income of $78,000.

Hidden EMR Costs

The question that physicians almost always ask, and it is a fair one, is what extra fees will I have to pay that are not immediately obvious? In short, for what else will Dr. Long-pockets be obliged to pony up?

The networking costs are usually included in the vendor’s monthly fee for the software, but you can sometimes lease them on a monthly fee. Fees for technical and costumer consultation are ordinarily extra.

You need to consider two kinds of costs. A hard cost is what you pay for the computer and networking hardware plus EMR software. Then there are those sneaky, soft, hidden costs that jump out at you.