How One Eye Care Clinic Turbocharged Its Ophthalmology EHR Investment and Gained 41% ROI

Every day I go out into my garden and harvest a bowl of tomatoes and peppers like this one. The ROI for the $20 and some sweat equity I spent on seedlings earlier this spring is sweet and savory. My grocery bill’s a little lower and my meals tastier.

A 13-provider eye care clinic just down the road from me is seeing even sweeter ROI from an ophthalmology EHR software purchase in 2007—41% over five years, according to an article recently published in Ophthalmology and summarized here.

Bonus: This sweet ROI came in during a period before the feds were offering payment boosts for Meaningful Use.

Show Us the Numbers

$500,250: Amount Asheville Eye Associates spent to implement the new ophthlamic EHR software and hardware.

$600,000: Amount the practice saved in 2011 on reduced back office staffing. The practice saw some savings during the first year of implementation because they were able to reduce the number of transcriptionists and medical records staff. That initial savings paid for new HIT support staff hires. By year four, the practice was able to reduce billing and reception staff as well, and the annual savings from the lean, EHR-enabled staff is now at $600,000 annually.

Between $216,000 and $385,000 a year: Increases in optical shop revenue that study author Dr. Robert Wiggins attributes to electronic prescribing. Patients can still get paper scripts to take somewhere else, but the numbers suggest they relish the convenience of fulfilling their scripts on site.

$800,000: Increase in annual clinical revenues by the fifth year after implementation. After the installation of the new ophthalmology EHR software, clinician productivity dipped as doctors learned to use it. By the second year, clinician productivity was back up to pre-EHR levels. By the fifth year, physicians realized they had more time to see patients. The practice saw an average of 1.23 more patients a day, which created the $800,000 increase.

Caveat Emptor

Asheville Eye Associates saw no monetary gains during the first year because they had to hire an HIT guy, scan paper records, and pay for EHR software maintenance. Doctors worked longer hours that first year and patients waited longer to see them. The practice uses scribes who double as technicians so that the doctor can focus on the patient and not the computer. However, the practice used scribes even before the installation of the ophthalmology EHR software. Industry exerts predict that the best ophthalmology EHR systems will make scribes a hot commodity, and they’ll be cheaper to hire than transcriptionists. As ophthalmology software evolves, more of these responsibilities will be automated, freeing up time for physicians and rendering some staff redundant.

Dr. Wiggins tells Medscape that his practice is mostly consultive, and that some eye care subspecialties may not see the same kinds of savings from EHR. According to a study published in JAMA earlier this year, some eye care practices will see revenue losses, even with Meaningful Use incentives.

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