• Efficiency savings
• Improved outcomes of care
• Additional revenue generated
• Non-financial gains (e.g., increased patient satisfaction, decreased provider time at work, increased employee satisfaction)
• Increased knowledge of the patient population.1
Furthermore, the investment cost in healthcare is also not just financial. Providers need to understand:
• The time cost spent comparing technologies before choosing one to implement
• The time that will go into learning a new technology added to a practice workflow
• The time that goes into staff training to learn use the technology
• The time that goes into educating patients about the technology
• The psychological or emotional cost that may arise when staff are resistant to adopt new workflows.
Because starting a new practice is expensive, a lot of providers choose free EHRs that come with patient portals to reduce upfront investment costs. Usually, there is a significant time investment for learning how to use this kind of software, but this varies significantly. I recently ditched an extremely cumbersome free EHR to one that integrates with my patient engagement software.
Then something really amazing happened. In less than 10 minutes of using the EHR, I was able to start a patient note and prescribe a medication for a patient. I’ve learned to use at least five different EHRs since medical school, and this was the first experience I have ever had where the learning curve was essentially zero.
Is the software perfect? No. There is no perfect solution for digital medicine (yet). But, right now this EHR is affordable (can’t get more affordable than free) and easy to use. It’s a sign that we are moving in the right direction. With my (gigantic tablet sized) iPhone 6+ I can use the EHR’s accompanying mobile app to document and prescribe on the go.
What does this mean for patient engagement? Well, consider this example. A patient of mine called me to refill a prescription over the weekend. Although her primary doctor had said he had ordered it, it was not waiting for at the pharmacy. She was leaving for vacation the following week and needed to fill it before she left. I discovered that her primary physician was unavailable. Because I knew this was a medication she used regularly I decided to refill it for her. I was able to do this through my mobile HER, and the patient was really grateful for the convenience. I used this opportunity to invite her to sign up for the patient portal, which will enable me to deliver test results and send secure messages to her.
Patients evaluate doctors’ quality of care delivery on a variety, nonmedical factors, including:
• A physician’s communication skills during a clinical encounter
• Communication between a physician and patient outside of the office visit
• The ability to make an appointment, contact a physician, or be seen in a timely manner during a clinic visit. 2
In this case, the return on investment of learning to use a mobile EHR was greater patient satisfaction, and likely greater outcomes since she was able to stay compliant with her medication regimen. The efficiency of care delivery was also better through this solution. Overall, I was very satisfied with the experience and happy to be able to offer services that my patient judged as high quality.
So when evaluating a new technology to add to your practice, consider weighing the monetary and non-monetary costs. If a technology is cheap but incredibly painful to learn to use, you might want to spend a little more upfront for something that offers more value. But, if you have found a technology that is both inexpensive and easy to use well, you’re ROI is going to be huge.
1 http://www.getrealhealth.com/return-on-investment-from-health-it-enabled-patient-engagement/
2 Detz A, López A, Sarkar U. Long-Term Doctor-Patient Relationships: Patient Perspective from Online Reviews J Med Internet Res 2013;15(7):e131
Molly Maloof MD runs a boutique medical practice in San Francisco & consults with tech start ups. Follow her @MollyMaloofMD.
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