The thing that impresses me the most is that I can get a student or resident up and running on AC in a few hours. Take that e clinical works. Most people do not have a significant drop in productivity with AC, another thing to consider.
Wow, I wish that had been the case with us. Our 4-provider practice revenue dropped dramatically the first year. But, that is not to say AC per se is to blame; it was the entire shift to the EHR. Everyone in the office had to learn to use it, not just the providers, and our schedule was often limited by the slowest user, often nursing or front office. Remember the pleasure of having every encounter require the unreimbursed workload of a new patient? In a practice with a lot of older patients with multiple problems this would take a minimum of 45 minutes per patient, even if we could only bill a level 3 exam. Overall I figure going electronic cost us about 4 times the incentive money would have brought if we had gone after it (we didn't). I feel the question is not whether to choose AC over other electronic systems... my answer remains a resounding "yes"... but whether to go electronic at all.
David Grauman MD Department of Medicine Commonwealth Health Center Saipan, Northern Mariana Islands
