Running head: INTEGRATING EMR 1

Integrating Electronic Medical Records

And Disease Management
Eduardo Santoyo
HCA 626
National University

January 24, 2016

Abstract

The case study will analyze the aspects of the integrating electronic medical records for a

medical practice. This author will discuss the concept of Pay-for-Performance, advantages and

limitations of cost-benefit analysis for IT adoption decisions, IT readiness for a group practice,

and challenges and incentives that small practices face in regards to implementing an electronic

medical records system.

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Integrating Electronic Medical Records and Disease Management

In todays fast growing healthcare information systems, a study was done focusing on the

planning, development, and impact of electronic medical records (EMR) on Dryden Family

Medicine (DFM). Their implementation of an EMR from their primarily paper-based system

and the transition that occurred for the practice will be discussed. The practice started as a small

medical practice, but as the practice grew, there needed to be changes to the methods of keeping

up with patient medical records and the practice adopted an EMR system.
Pay-for-Performance
Pay-for-Performance (P4P) is an umbrella term for initiatives aimed at improving the

quality, efficiency, and overall value of health care (HealthAffairs.org, 2012). These types of

initiatives have started to provide financial incentives to hospitals, physicians, and health care

providers in order to make improvements and achieve optimal outcomes for patients and their

health. With the Affordable Care Act expanding the use of P4P, especially with Medicare and

Medicaid, eligible providers and hospitals started implementing and starting to meet certain

quality metrics. DFM decided on a subset of 30 of these metrics to focus and report on. They

received a bonus payment for meeting the reporting standards during 2007. Having the concept

of P4P, it is encouraging medical practices to set up their practices in order to meet the

requirements and earn monetary incentives are definitely a huge advantage to the system. One of
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the focuses of this case study looks at how DFM was able to adopt the EMR system, and what

advantages and disadvantages that came with implementing this system.

Cost-Benefit Analysis
There were some advantages and limitations of the cost-benefits analysis for IT adoption

decisions. One of the advantages of adopting an IT system was that the billing system was easily

integrated into the new system. The electronic billing function had to work correctly the first

time, because the practice could not afford disruptions in its revenue stream (ONeill &

Klepack, 2010). Though they saw success with the billing system, there was pressure from the

start relying on the success of the new system. The office manager of the practice took on the

role of IT support person because they could not afford to hire an outside consultant. So the

office manager acted as the internal consultant, who would answer day-to-day IT questions,

they would then train others in the office. By doing this, the office was able to save in revenue

costs.
One of the limitations was that they had no experience in dealing with EMR systems, as

ONeill and Klepack (2010) discussed that picking the wrong vendor could destroy the

continuity of the patients medical record, incur significant additional costs, and disrupt patient

care and staff functions. The loss of revenue that would occur if the wrong vendor were chosen

would have a huge impact on workflow and patient care.

Adoption of EMR
If there were a possibility that DFM chose to not switch over to EMR, there would have

been many disadvantages. The practice would not be able to maintain the workflow in

comparison to those who had adopted an EMR system. Other practices would be able to

communicate with others via electronically and they would still be trying to fax and mail their

patients records, which are always a hassle, disrupting patient care and workflows.

Prescriptions would have to be called in, lab orders would be done through paper forms. As their

patients started to get older and come with more health issues, the size of their paper records
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increased day by day due to their chronic health problems, which required complete

documentation. Keeping track of patient records also would have kept being an issue for the

practice. Losing a chart would lead to a time-consuming search process.

IT Readiness
There are certain milestones that need to be achieved, in terms of IT readiness, before a

group practice decides to implement EMR system. One of the major milestones would be to

pick a vendor to work with in implementing the EMR. They would have to look at the vendor

and how they did with the following criteria: service, support, and system reliability; product

maturity; financial stability of vendor; ease-of-use; security; regional familiarity/organizational

culture; and finally, cost. A factor that tends to arise when it comes to IT, would be for the end

users to be prepared for a system that could take time and effort to learn. The staff would all

have to agree that moving to an EMR system would be the best option in regards to patient care,

as well improving workflow. For medical staff or providers who were not onboard with the

transition, this could cause some resistance in implementing and following through with the

effectiveness and thoroughness that an EMR system has with patient care.
Incentives
There could a lessened incentive or different set of challenges for smaller practices to

take on HMIS project like that of EMR implementation than a large-scale health service

organizations. When smaller practices are faced with the issue of taking on EMR system, cost

would be huge factor. Implementation of such a system requires a lot of money and time to

invest. Money would be needed in order to shop and research vendors; train staff; time that

would take away from patient care; IT issues that could occur. Those are some of the challenges

that could occur, even when monetary incentives brought forth with Affordable Care Act and the

Meaningful Use objectives. Some smaller practices may not see the incentives as much as to

bring on so much more responsibilities and hassle of taking on the challenge of implementing a
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EMR system. Where as large-scale organizations would be able to afford such an endeavor and

would probably have more support than that of a smaller practice.

Conclusion
This case study looked at the Dryden Family Practice and their implementation of the

EMR system. The advantages and disadvantages of working with an EMR system were

explored. Cost of adopting an EMR was explored, as well as IT readiness. Coming from a

background of working a huge healthcare organization, the exposure to EMR has been extensive

as well as enlightening. From personal experience, paper records were such a hassle from

releasing records and having to carry laboratory requests to labs, where everyone waited around

for almost more than hour. Working with electronic medical records has made my job easier, as

well as fun, now that the knowledge has been obtained as to how and why healthcare must move

forward when it comes to health IT.

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References
James, J. (2012, October 11). Health Policy Brief: Pay-for-Performance. Health Affairs.

Retrieved from http://www.healthaffairs.org/healthpolicybriefs/brief.php?brief_id=78.

Laudon, K.C., & Laudon, J.P. (2012). Management information systems: Managing the Digital

Firm. Upper Saddle River, NJ: Pearson Education, Inc.

ONeill, L., & Klepack, W. (2010). Integrating Electronic Medical Records and Disease

Management at Dryden Family Medicine. In J. Tan, & F.C. Payton (Eds.). Adaptive

health management information systems: Concepts, cases, and practical applications.

Sudbury, MA: Jones & Bartlett Learning.

Tan, J., & Payton, F.C. (2010). Adaptive health management information systems: Concepts,

cases, and practical applications. Sudbury, MA: Jones & Bartlett Learning.