I do have to say that Mike Gleason, put forth a very enlightening and engaging peace. And I drew more from that one piece then the entire conversation that went along with this article..

Athenahealth is simply one more purveyor of contracted-out billing and collector of billings. It is not surprising that Mr. Bush cannot explain the economics of investing in EMR systems. His business simply absorbs at a ridiculously high cost to his customers the hassle of dealing with obtaining payment. Athenahealth has at its disposal the entire revenue stream from which it skims its fee. Not a task that requires much knowledge about much of anything.

One factor that I believe plays a role in the low pace of installation of EHRs, and the underutilization of EHRs once installed, is, quite simply, inertia.

As a practicing physician having used two different EHRs over 10+ years of practice, I can say definitively that a good EHR can help a physician be more efficient, improve clinical quality, and improve patient satisfaction. There are a LOT of docs who (like me) would never want to go back to paper.

However, it’s an unavoidable reality that the initial adoption for every physician involves a temporary period of lower efficiency and substantial frustration. As EHRs evolve in usability, reliability, and ease of installation and configuration, this will lessen, but it will never disappear. You have to trudge uphill for a while before you can coast downhill, far beyond where you started.

And for most human beings, it’s REALLY hard to make that uphill trudge, even if you believe that the other side is better than where you are now. It’s one of the oddities of human psychology, but one which you can see all around you every day in 1,000 different ways.

So the diffusion of EHR technology is not like the diffusion of fax machines or cell phones. Maybe it’s more like the transition of America from a society where nearly everyone smokes to one where non-smoking is the norm. As with smoking, EHR adoption will occur from a combination of the gradual accrual of doctors who have never known any other way (like kids who never smoked), attrition of those who have never used an EHR (like the gradual disappearance of smokers), and the hard-as-heck efforts of those who have gone from using paper to using EHRs (like folks who have made the switch from smoking to being smoke-free).

“It will be imperative that doctors move to a digital modality as their customers will increasingly expect such out of them.”
Consumers want access to their info online, hence PHR. If the doc isn’t going to make it easy to access, they will go to someone who will, Privacy concerns? HA! Facebook, Youtube, Twitter – Doesn’t look like there’s too much concern about privacy.

“What the real focus needs to be is on value delivered and the value proposition … and what type of customers that practice intends to serve.”
Right- the next generation of healthcare consumer wants a relationship based on information that’s easily accessible. Paper just won’t cut it.

And here’s a survey that shows a bit of hope coming with the new set of med school grads:
“Sixty-two percent of medical students said having an electronic health record system at the place they choose to practice is very important, according to a survey by Epocrates. Twenty-eight percent of medical students surveyed said EHR availability was important in choosing a practice, while 8% said it was somewhat important. Only two percent of respondents said EHR availability was not important in choosing a future practice. ”

Hopefully we can get to them before they experience too much EMR cynicism/skeptism from the older docs.

Emotion is exactly where we need to go. Forget ROI, better customer/patient relations is where the value is. The satified patient refers their family and friends leading to a growing practice.

The question to answer is not, ‘What’s my ROI” it’s “How will it build my practice.”

Yes, it’s a bit more intangible, but the good sales rep can do it.