Electronic medical records: one group's experience. (Savings of $3,300/Year Per Provider).

BIG SKY, MONT. -- Medicalsoftware salespeople have been known to promise the moon:

Here's a more realistic view of what physicians can expect to achieve through a switch to a full-bore electronic medical record (EMR) system and related information technology based on the experience at the Geisinger Health System, Danville, Pa. This largely rural health care organization with more than 600 physicians and an HMO with 300,000 patients has made a made a major commitment to the paperless office.

Geisinger adopted the EpicCare ambulatory EMR system to handle the entire clinical enterprise from patient history to medications, test results, documentation, order entry and health maintenance. EpicCare is just one of many competing products; the key is to select a vendor who can provide a database that handles everything--inpatient and outpatient records, radiology and laboratory reports--rather than trying to get different databases to interact, Dr. Eric J. Bieber explained at an ob.gyn. update sponsored by the Geisinger Health System.

* Cost savings. In Geisinger's preliminary return-on-investment analysis, the EMR system has saved nearly $3,300 per provider per year through reduced medical record labor, including chart creation, data entry, and repeated chart pulls. Costs for mailing and copying records are down as well.

Medical transcription costs have dropped by one-third. In some departments, the number of lines transcribed per month is down by 70%, said Dr. Bieber, chairman of ob.gyn. at Geisinger.

Even though the EMR system is still being phased in--only about 380 of the HMO's 600 physicians are fully connected at this point--Geisinger now creates 375,000 fewer printed laboratory and radiology reports per year. Electronic popup reminders suggest that physicians preferentially utilize drugs that are on the HMO's formulary. The resultant savings attributable to improved formulary adherence amounts to roughly $1,000 per primary care physician per year. Physicians still have the option of overriding the ...