128 ADOPTION OF AN ELECTRONIC MEDICAL RECORD: DOES IT IMPACT CLINIC REVENUE?

Abstract

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Practice Patterns, Cost Effectiveness I1 Apr 2012128 ADOPTION OF AN ELECTRONIC MEDICAL RECORD: DOES IT IMPACT CLINIC REVENUE? Jessica Hammett, George Bailey, and Tracey Krupski Jessica HammettJessica Hammett Charlottesville, VA More articles by this author , George BaileyGeorge Bailey Charlottesville, VA More articles by this author , and Tracey KrupskiTracey Krupski Charlottesville, VA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.177AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Electronic medical records (EMR) for both health systems and medical practices are marketed as improving patient satisfaction, patient outcomes, and clinician workflow. Since the federal government has mandated that all physicians use EMRs by 2015 or risk decreased compensation, adopting an EMR has become imperative. The University of Virginia (UVA) purchased multiple products from Epic Systems Corporation, the nation's largest EMR provider, and implemented the outpatient application one year ago. We sought to ascertain how the transition to EpicCare Ambulatory (Ambulatory Medical Record Application) impacted clinic capacity, charge capture, and departmental revenue. METHODS Using seasonally matched six-month time periods (September to February) pre- and post-Epic implementation, we analyzed outpatient evaluation and management (E & M) coding performed by ten University of Virginia Urology faculty. The overall number of visits, level of service charges, and collections were assessed at the provider level before and after Epic implementation. There was no change in coding personnel or coding analysis. During this time period, we had faculty turnover leading to only eight faculty actively employed post-Epic implementation so outcomes are compared at the provider level. Chi square analyses were performed. RESULTS Post-Epic implementation, we experienced a substantial increase in number of visits per provider from 664/provider to 773/provider. A larger percentage of outpatient initial visits (17 to 20.7%), follow up visits (9.4 to 19.6%), and outpatient consults (0.6 to 1.5%) were coded as level 4 post-Epic implementation. Level 5 visits decreased for new patients (6.5 to 3.1%), but increased for follow up patients (0.6 to 1.5%). All were statistically significant (p=0.0001). When assessing the charges and collections from the two time periods, we found pre-Epic charges were 5.502 million with 1.635 million in collections. This is $163,000 per provider. In comparison, post-Epic, faculty charges were 5.169 million with 1.531 million in collections for $191,000/ provider. CONCLUSIONS Although we anticipated that a decline in clinician workflow during the adoption period would adversly affect outpatient revenues, this did not occur. In spite of implementation during an econcomic downturn, we encountered more patients per provider, experienced a slight improvement in our coding levels, and slightly improved in collections during the early post-Epic period. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e53 Peer Review Report Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jessica Hammett Charlottesville, VA More articles by this author George Bailey Charlottesville, VA More articles by this author Tracey Krupski Charlottesville, VA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...