Q: We are looking to transition to electronic
medical records (EMR), but are worried about the
cost and the disruption to operations. What options
can we consider?
A: Transitioning to an EMR requires
a well thought out, long-term plan. It should be
done one step at a time so your providers and staff
can adapt as you move forward. There’s no need to
One first step can come at no additional operational
or capital cost. You can choose a digital online
transcription company that maintains a permanent
searchable database of your transcribed records.
This will give you a good feel for the benefits of
EMR without disruption to your doctors’ daily
routine. They can continue to dictate via handheld
recorders, a toll-free call-in dictation service, or
a direct pick-up voice collection system like Lanier
or Dictaphone. And you can have the reports
electronically at your fingertips the next day.
How can digital online transcription serve as a
mini-EMR? Here’s an example:
A patient calls to inquire about a previous visit.
Instead of taking a phone number, looking for the
chart and having to call the patient back, you can
go to your page on the transcription company’s
Website, type in the patient’s name or medical
record number, and up come the transcripts of all
the patient’s visits. The call is handled on the
spot and everyone is happy. No chart to find and
replace, no searching for misplaced notes, and a
satisfied patient — with 15 minutes of a very busy
day saved on this one transaction.
Another example: The doctor gets an after-hours call
and needs the
details of the patient’s visits. He can go to the
Website from his home or hospital computer and have
the information in seconds.
As the health information technology industry evolves,
the medical transcription company that you choose
should be one that is fully capable of interfacing with any EMR
system that you may select in the future, via
the industry standard Health Level 7 (HL7)
protocols. Some suppliers of EMR systems sell
modular “bolt-on” packages allowing a
one-step-at-a-time approach, versus the costly and
sometimes disruptive all-or-nothing “transition.”
Practices that are plunging head-first into
full-blown EMR systems are often being told that
they can justify the mega-dollar investment by
eliminating transcription altogether.
However, we have found it usually doesn’t happen
that way. Building templates covering all situations
to the satisfaction of everyone in the practice, as
well as interacting with the
computer, is very time
consuming for the doctors. The time lost from
patient care is costly and the stress on the doctors
contributes towards loss of staff morale. As a
result, the return on investment is lost and the
level of patient care is not impacted for the
A word of caution: With any EMR, you will likely need to interface
with many medical facilities and business partners
as the national network grows. Many EMR providers
charge up to $50,000 for each two-way interface.
Negotiate these costs before signing a contract!
Jumping too quickly into expensive EMRs can cause serious financial
consequences due to reduced patient counts and the
loss of frustrated doctors. The one-step-at-a-time
approach seems the most prudent. Again, what’s the
W. Allen Clifford is president and CEO of Resource
Providers, Inc., a Web-based transcription company
that also creates EMR packages; 813-282-8889 (toll-free 866-660-4774); firstname.lastname@example.org.