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Can I throw my computers out and go back to paper charts?

Provided by: Jennifer Kirschenbaum, Esq.
   January 10, 2017
Question:

Hi Jennifer,

I have been doing EMR since 2009. I qualified and have been paid the maximum allowed incentive payments. The reality of the situation is that I had to cut my practice by at least 35% to keep up with the constant computer entry and I also feel that it has sabotaged my patient relationship as I have my back to them for most of their office visit while I punch away at a touch screen to get all of the required date entered.  My system is actually very good and quick, but there is a lot that has to be included in a note (especially for any Medicare patient) as anyone knows that has consciously reviewed the laws. 
 
So the realization is that for a few pieces of silver, I have actually destroyed my practice in terms of patient visits per day, income per day and patient satisfaction not only because of a less personal touch, but also because of long wait times to get new patients in (upwards of 4 months) or even to get an established patient in.  So here I sit at 7:30 PM on a Thursday night as I do most every night finishing up my long day.  No life at all. 
 
How can I go back (legally) to written records and satisfy the requirements for proper note keeping? 
 
Do I have an obligation to continue to do EMR going forward since I have been doing it for so long? .. or because I accepted the incentive payments?
 
Is it acceptable to only do EMRs on certain patient groups (Medicare, Federal, Personal Injury) and do paper records for everyone else?
 
I appreciate your input.  I need to get back on tract so I can retire before age 90.
 
Thanks!

Dr. L

Answer: 
 
Dr. L, there is no turning back.  Of course, that is not true, you are a private business and you can chuck your computers and software any time and go back to paper, the issue is will your payors go along for the ride?  Medicare and the privates are LOVING the ability to data mine, electronically audit, and completely dismantle patient care turning medicine into paper pushing.  Can you stay in Medicare using paper records? Yes. You will be penalized.  Can you participate with private payors and use paper? Depends on the payor requirements - but most, yes. You will certainly be wading in murky waters, and there will definitely be (whether minor) a financial penalty at least from Medicare. 

Another option is to chuck the technology and the payors at the same time, and go concierge.  Of course enough patients would have to be on board...
Provided by:  Jennifer Kirschenbaum, Esq.
Question:
Hi Jennifer,
I have been doing EMR since 2009.  I qualified and have been paid the maximum allowed incentive payments.  The reality of the situation is that I had to cut my practice by at least 35% to keep up with the constant computer entry and I also feel that it has sabotaged my patient relationship as I have my back to them for most of their office visit while I punch away at a touch screen to get all of the required date entered.  My system is actually very good and quick, but there is a lot that has to be included in a note (especially for any Medicare patient) as anyone knows that has consciously reviewed the laws. 
 
So the realization is that for a few pieces of silver, I have actually destroyed my practice in terms of patient visits per day, income per day and patient satisfaction not only because of a less personal touch, but also because of long wait times to get new patients in (upwards of 4 months) or even to get an established patient in.  So here I sit at 7:30 PM on a Thursday night as I do most every night finishing up my long day.  No life at all. 
 
How can I go back (legally) to written records and satisfy the requirements for proper note keeping? 
 
Do I have an obligation to continue to do EMR going forward since I have been doing it for so long? .. or because I accepted the incentive payments?
 
Is it acceptable to only do EMRs on certain patient groups (Medicare, Federal, Personal Injury) and do paper records for everyone else?
 
I appreciate your input.  I need to get back on tract so I can retire before age 90.
 
Thanks!
Dr. L
Answer: 
 
Dr. L, there is no turning back.  Of course, that is not true, you are a private business and you can chuck your computers and software any time and go back to paper, the issue is will your payors go along for the ride?  Medicare and the privates are LOVING the ability to data mine, electronically audit, and completely dismantle patient care turning medicine into paper pushing.  Can you stay in Medicare using paper records?  Yes. You will be penalized.  Can you participate with private payors and use paper?  Depends on the payor requirements - but most, yes.   You will certainly be wading in murky waters, and there will definitely be (whether minor) a financial penalty at least from Medicare. 
Another option is to chuck the technology and the payors at the same time, and go concierge.  Of course enough patients would have to be on board..

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