Healthcare is undoubtedly becoming more technology driven, and the push to keep up with this trend can be particularly challenging for solo and small physician practices, which may have tight budgets and little or no dedicated IT staff. Adopting and implementing electronic health records and other forms of health IT require good technical support and change management, which can be expensive and hard to find. And EHR adoption can be very disruptive, especially if not done well.
According to the American Medical Association, more than 80% of physicians are now using EHR systems and the MACRA implementation regulations, released in draft form last month, will require some level of certified EHRs. This will put additional pressure on solo and small practices that haven’t yet adopted EHR to do so, if they want to get the incentives.
“This will likely be enough to motivate some of the holdouts to adopt, but until the systems themselves get better, cheaper, easier to use, I suspect that many providers will hold off investing,” says Julia Adler-Milstein, a health policy expert at the University of Michigan.
As noted, some physicians are leaving private practice because of the shift to value-based reimbursement and need to adopt EHR.
But while financing and implementing EHR and other health IT can seem daunting to small businesses, there are real advantages to having them. For one, those that choose to go without EHR lose out on meaningful use incentives and face reimbursement penalties. EHRs also reduces paperwork and storage issues and helps to improve productivity and efficiency. There is also practice management software available to help doctors run practices more efficiently, saving time and money.
Help is there, if you know where to look. While some of the major EHR vendors cater mainly to hospitals, there are ones that focus on small practices and their unique needs. These include firms like PrognoCIS, Kareo, e-MDs and SOAPware. A survey by Medical Economics rated SOAPware tops among 20 EHR systems for care quality, meaningful use, patient portal, and technical and clinical decision support. The cloud-based system offers concierge EHR implementation support and personal coaching.
Choosing a cloud-based option is often the way to go for small practices, since it relieves them of having to host on site servers and a dedicated IT team. Moreover, if they run into a snag, it’s the vendor’s responsibility to fix it.
Vendor support and ease of use are key for small practices, Montana internist James Logan told Business News Daily.
According to research firm Black Book Rankings, the chief reasons for choosing cloud-based EHRs are ease of implementation, system updates, usability and custom tailoring. A four-month poll of 5,700 small and solo practices found that EHR satisfaction increased to 81% in 2015, compared with just 13% in 2012, as a result of cloud-hosted options.
About 80% of small practices said pricing is the main factor in selecting a cloud EHR, while 38% expressed concerns about privacy and security with these systems. A growing number of conversions—79% in 2015 versus 64% the previous year — are using software-as-a-service type implementations, propelling more practices to cloud-based products, the survey showed.
“The focus of healthcare technology vendors needs to be on mobile, cloud, and data integration to successfully meet the future demands of the changing healthcare landscape,” says Doug Brown, managing partner of Black Book.
In addition to EHRs, there are a growing number of digital platforms that allow doctors to access practice-related information and share insights and best practice, according to the Deloitte Center for Health Solutions. With hand-held Epocrates, for example, physicians can consult peer-reviewed disease content, review practice guidelines, check on potential drug interactions and send and receive secure texts, among other features. The athenahealth service costs less than $200 for a full year.
Similar services include Medscape and Sermo. The latter bills itself as the a social network for doctors both stateside and globally, and includes features such as a virtual doctors’ lounge and medical crowdsourcing. The app also pays doctors for their perspectives on medical matters.