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Kathy Mahdoubi, Senior Correspondent | September 28, 2009
Many institutions, when faced with the cost of installing an EMR at somewhere between $20,000 and $30,000, often find that they have to eliminate other costs, including the cost of transcription. This represents a huge paradigm shift for many physicians, said Belton.
"It's turned doctors into typists," he said. "In this business, you don't get paid for what you do. You get paid for what you document."
Belton referred to the industry's "dirty little secret" -- that according to a recent study, 15 percent of doctors said EMRs slowed them down and added, on average, a half hour to an hour and a half to their workload. The study also found that 70 percent of physicians considered EMR adoption 'considerably challenging,' he said.
"EMRs allow doctors to practice better medicine, but it takes time away from focusing on the patient," Belton said.
Dr. Brian Zimmerman works in Miami Valley Hospital's Emergency and Trauma Center in Dayton, Ohio, and considers Dragon Medical one of the primary reasons why the facility has been able to go electronic.
"The ER was first in the hospital to go live with the EMR. We had CPOE [computerized physician order entry], documentation and reporting -- everything. We called it the Big Bang Go Live, but without transcription our physicians revolted," said Dr. Zimmerman. "We went live in Oct 2006 with Dragon available from day one. At first the physicians were hesitant, but then they embraced it."
Dragon Medical seems to be picking up steam, especially on the reimbursement front. "We've seen several studies in physician practice settings that showed $10-13,000 per year in increased reimbursement because of improved notes and coding," said Belton.
Nuance released version 10 of Dragon Medical last year, and now Belton estimates that 100,000 doctors -- about 1 out of 6 doctors -- are using the software, which is compatible with most of the major EMR vendors and allows doctors to speak and enter text into any free-text field in patient records, as well as populate referral forms and billing documentation.
However hospitals and physician offices end up adopting it, the EMR is sure to be on the minds and budgets of anyone hoping to cash in on the ARRA's stimulus monies. Stay tuned as the Obama administration continues to refine the criteria for meaningful use of health IT stimulus funding and as EMR product certification bodies like CCHIT begin to take on more authority by the end of the year.
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