Going Paperless Without EHR?

In a June 2006 interview with Mark Leavitt, Chair, Certification Commission for Healthcare Technology, Leavitt commented that “a practice that waits to adopt EHR [electronic health record] must consider an important ‘downside’: They need at least three months for EHR implementation, one year to collect data, and at least another year to put quality improvement mechanisms in place. The bottom line is that it will take them up to three years from the time they purchase [an EHR system] until they are ready to take full advantage of pay-for-performance reimbursement, and waiting until the last minute to go electronic could end up costing them money.”

“Electronic document management tools for office practices are available now without implementing a full EHR system,” states Evan Steele, CEO, SRS Software, Inc. “We have the capability today to eliminate patient charts, and improve productivity and efficiency without the multi-year timeframe or high cost of a comprehensive EHR system.” The key for SRS Software has been using readily-available technology to create a simplified approach to going paperless.

Are Practices Converting to EHR?

Research findings from the 2005 Medical Group Management Association (MGMA) survey of more than 3,300 medical group practices shed light on challenges of adopting EHR technologies. Proponents claim that paperless records shared across health care settings could: shrink US medical costs by hundreds of billions of dollars annually, reduce medical errors, and improve the overall quality of patient care. “Despite these stated benefits,” Steele remarks, “physicians face significant burdens—especially time for data entry and costs—that impede uptake of comprehensive EHR systems.”

“Time needed for data entry by physicians during clinical encounters is a significant factor. Imagine the president of UPS inputting data about package deliveries—the productivity loss would be enormous,” Steele remarks, pointing to evidence from the MGMA survey that manual entry of patient exam information using an EHR reduces physician productivity by up to 15%.

What About Costs?

“Small- and mid-sized practices could afford EHR if the return on investment [ROI] were there,” says Steele. “However, without reliable ROI, the initial investment is often lost, making EHR ‘unaffordable’ for many practices.”

According to the same MGMA survey, just 14% of all medical group practices had invested in an EHR, identifying an average purchase and implementation cost of $32,606 per full-time physician. Maintenance costs were an additional $1,200 per physician per month. Smaller practices had the highest per-physician implementation cost at $37,204, and the average cost for EHR implementation was about 25% more than initial vendor estimates. Lack of capital resources to invest in EHR was cited as the top barrier to adoption. Also, practices are not convinced EHRs will improve their performance or justify return on investment in terms of cost and quality.

In comparison, SRS Software and other groups dedicated to simplifying practice administration and progressing towards paperless health care can cost practices up to 75% less per physician, depending on the size of the practice, according to Steele.

Keep It Simple!

“To help counter rising costs, shrinking reimbursement, and heavy patient volume, physician practices need a practical approach to organizing and retrieving patient information,” says Steele. Existing technologies offer today’s busy medical practices common-sense solutions to document management. In fact, according to Steele, “physician groups that implement a document management solution not only do well—but also thrive—without an EHR!”

One such solution is SRS Chart Manager™, available from SRS Software. Medical practices of all sizes, from primary care to subspecialties, use SRS Chart Manager to eliminate paper charts, streamline operations, improve information flow, enhance patient care, and reduce costs. The software, according to Steele, is “easy to use, easy to learn, and easy to afford.”

Key features of the SRS Chart Manager include:

  • A paperless system—The software program scans paper documents into a database that allows practices 24/7/365 access to patients’ charts from any remote location through a high-speed Internet connection. The product is designed to work with any type of computer or electronic tablet.
  • Physician workflow improvements—Doctors can review all patient information electronically rather than pulling paper charts. The system allows physicians to do electronic prescriptions, flow sheeting, and order entry; attach lab or imaging reports; and digitally sign reports.
  • Office staff workflow improvements—Nurses can handle 35 to 40 phone messages each day with quick access to test results and prescription information. Messages for physicians at different office sites can be placed, accessed, and acted-upon quickly.
  • Barcode technology—Filing of paper documents is automatically digitized and filed in patient charts.
  • Ease of use—The system’s components are extremely user-friendly.
  • Lab interface—Immediate access to patient test result data is available electronically, routed from the lab directly into patient charts and physician inboxes for review and digital approval.
  • Digital imaging interface—Digital images (x-rays, ultrasound, CT scans, etc) are downloaded and placed directly into the patient’s electronic chart for viewing on the computer.
  • Savings on forms, paper, printing, and faxing costs—All forms are produced electronically from within SRS and are printed when needed by physicians and staff.

The number of records lost has been zero for practices using the SRS system. Another impressive statistic is the time it takes to train your practice’s physicians—approximately 20 minutes per doctor. Such factors contributed to SRS Software receiving “First Honors” for Best Document Imaging Solution at the May 2006 TEPR (Towards the Electronic Patient Record) annual meeting. This award recognizes SRS as an industry leader in health care document management.

“No one can predict the outcome of the federal eHealth initiative, but SRS can help practices become more efficient, effective, and organized starting today,” Steele says.

To learn more about EHR implementation, services, and the first steps towards paperless, check out these past articles from For the Business of Medicine:

To read more about the national eHealth initiative, see www.hhs.gov/healthit/ahiccharter.pdf.


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