Want EMRs to succeed? Pay doctors to use them

You know, sometimes an answer is right in front of us. The American College of Physicians is handing you the cheat sheet, guys, so you don't need to furrow your brows anymore. If you want to get doctors started using EMRs, pay them for the time they spend using them!

I know, you're saying "Hey, nobody pays doctors to use telephones or review charts." And yes, I hear you--those activities have become part of a practice's overhead, rightly or wrongly. In recent years, handling incessant transactions with managed care companies has, too.

Should EMR/PHR reading, interpreting, analyzing and what-have-you be reimbursable activities, as the ACP suggests? Well, according to the old school of thought--which classifies those activities along with making phone calls--definitely not. But when you consider the way overhead has expanded and pay has dropped, that argument just doesn't make sense any more.

I've said this in prior columns but it bears repeating: Let's face it, health plans, at this point in the game, you have more to gain from getting doctors online and using EMRs than they do. You're the ones who'll get the quality data to take to your employer customers. You're the ones who will have an easier time satisfying the NCQA. You're the ones who'll look good in business coalition report cards.

Yes, doctors want to provide quality care, but many know how to do that pretty darned well using old-fashioned methods. Perhaps they can do better, but so much better that they need to turn their professional workflow upside down, risk coding their claims wrong and spend a fortune to boot? That's understandably a hard sell.

So, for heaven's sake, get off your duff and begin paying them a few shekels for the time they spend on this new business model. If you can't swallow paying for what feels like clerical work, consider it some sort of blended clinical/administrative fee for a new age. Call it consulting on the side. I don't know how you'll justify it. Just do it.

My guess is that you'll see huge changes if you do. Hey, what if we all woke up one day and the big, bad EMR adoption problem went away? - Anne

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