Electronic Medical Records: one organization's experience. (This is the Future).

BIG SKY, MONT. -- Medical software 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 in 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 has 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. Geisinger's informal preliminary return-on-investment analysis indicates that 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%.

"All my dictations are now electronically available. I'll finish up a case at 9 o'clock at night, come down and dictate it, and at 6 o'clock the next morning, it's there. I can correct and sign it electronically, and it's done. That's incredibly more efficient than sending it off for transcription, waiting for it to come back, correcting it and sending it back, then waiting for it to come back so you can check to see if your corrections were actually made," noted 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. "The information is all there, and it's relatively accessible," he said.