How to Keep Costs Down in an EHR Implementation

July 7, 2020 by Antonio Arias, MBA, CHBME

Topics: Medical Billing, Practice Management, Medical Billing Company

doctor using EHR system in hospital

Even as the healthcare industry grows more and more driven by – and welcoming of – technological change, there are plenty of doctors holding onto their paper-based processes for as long as they can. The hardest thing to give up? Those trusted manila-folder medical records.

Though the industry-wide shift to electronic health records was incentivized by the U.S. government through the HITECH Act (along with the Meaningful Use criteria, which was later repurposed into the MIPS program), many doctors didn’t see the HHS’ financial incentives as compelling enough to make the switch. It’s easy to understand why: EHRs can be notoriously difficult to use, involve lengthy implementation timelines, require employees to learn new processes and tools, and are typically – most importantly – very, very expensive.

Despite the hefty EHR costs, there are some clear benefits to be gained from making the change. When properly utilized, EHRs make it easier to manage care for patients by:

  • Providing accurate, up-to-date, and complete information at the point of care.
  • Enabling quick access to patient health history and other records.
  • Allowing practices to securely share information with patients and other clinicians.
  • Promoting legible and complete documentation for more accurate billing and coding.
  • Reducing documentation errors and duplicate records.

How Much Does EHR Implementation Cost?

Several studies over the years have estimated that the overall cost of purchasing and installing the systems necessary to implement EHR ranges between $15,000 and $70,000. While costs obviously vary according to the size of the practice, it generally takes about 2.5 years for the average practice to recover the initial cost of its EHR system.

Of course, when it comes to larger hospital systems, the number can be much higher. One extreme example involved ProMedica, a health system based in Toledo, Ohio. In their financial statements for the first half of 2016, executives said their massive $1.9 million operating loss was “primarily driven by significant expenses due to the implementation of the Epic electronic health record launch.” The overall estimated financial impact of the Epic launch for ProMedica’s twelve hospitals in the first six months of 2016 was $19 million. 

Five Components of EHR Implementation

The total cost of EHR implementation usually consists of five distinct components. Depending upon a practice’s needs and resources, some of these components might incur higher or lower costs for them than it might for another organization.

  1. Hardware: Equipment that needs to be procured to host and manage EHR data. Could include servers, desktop/laptop computers, and any number of tablets or Internet of Things (IoT) smart devices.
  2. EHR Software: The actual EHR software cost could vary substantially whether the practice is purchasing the license for an on-site software deployment or subscribing to a cloud-based SaaS (software as a service) solution.
  3. Implementation Assistance: This could apply to any contractors needed to install the system, whether it’s IT technicians or even electricians who need to rewire the office.
  4. Training: Learning how to manage and get the most out of EHR systems can be a difficult undertaking. It’s best not to skimp on training, however. Recent studies have found that poorly managed EHR systems play a significant role in increasing physician burnout. 
  5. Ongoing Fees and Maintenance: Like any technology, EHR systems bring with them recurring costs in the form of renewing licenses, support fees, and continuing education.

How to Keep EHR Costs Down in an Implementation

1. Pin down your must-haves and a realistic budget before you start shopping. 

Costs vary so widely in the healthcare technology space that it’s vital to know what you need, what you want, what you can live without, and what you can afford before you start taking sales pitches. Speak with colleagues for vendor recommendations, talk to your medical billing service about what tools integrate with their system, and do extensive research before reaching out to vendors.

2. Consider a cloud-based solution. 

Hardware-bound EHRs are almost always more expensive than software-as-a-service (SaaS) or “cloud” powered systems. Cloud-based computing also means there are no costs associated with expensive in-house servers, and most solutions can integrate with the laptops, desktop computers, and mobile devices your practice already uses – no office-wide tech upgrades necessary.

3. Watch for hidden fees.

The many “free” EHR systems on the market come with major downsides – ads, poor load times, minimal functionality, and more – so they’re worth dodging altogether. As you go through the vendor selection process, ask every prospective EHR company what they charge and when; many vendors tack on extra costs for training, support, licensing, or other things.

4. Think long term. 

Wondering what’s more expensive than implementing your first EHR? Implementing your second EHR because you were so unhappy with the first one (more on that in a moment). Don’t let frugality over-dictate your decision-making. Make sure the system you select will support your needs, work well with your medical billing process, and help you improve efficiency office-wide over the long-term.

Transitioning From an Existing EHR System

In 2020, some medical practices have more experience with EHR implementations than they’d care to. After first deploying solutions in the early 2010s, many have moved on from their initial selections.

Nowadays, most EHR implementations aren’t about onboarding a practice to a digital solution from scratch, but rather about replacing their first choice of EHR – or even re-replacing their second choice – for a better solution. But when it comes to the actual implementation process, practices that fail to heed the lessons of earlier deployments are doomed to repeat their mistakes.

If your practice is considering implementing a new EHR, now is the time to revisit your prior experiences to remember what worked, what didn’t, and what challenges came up throughout the process. Sometimes, it’s about recognizing that the flip side of a good choice can still lead to issues if backed by the wrong approach. 

Keep the following concerns in mind as you plot the next phase of your practice’s EHR journey.

Do: Build buy-in with better workflows.

Earning the support of management, administrative, and clinical team members alike means making sure all parties understand the benefits of a new solution. One smart way to do that is to walk through how a selected EHR will adapt existing workflows across the front office, back office, and the exam room, showcasing to all parties how they’ll enjoy productivity and efficiency improvements.

Don’t: Expect too much change too soon.

But be careful not to overpromise (and underdeliver) on the new-and-improved elements of the implementation. If you say strong workflow improvements will be possible with the EHR, make sure you can back up your claims; if you can’t, you risk losing your team’s trust in the value of the switch.

Do: Conduct phased implementation.

If you have multiple office locations to onboard to a new solution, scaling your deployments over time is the best way to avoid getting overwhelmed. If all teams are put on a new platform at once, you’ll be all the more likely to see small problems grow out of proportion during those first few weeks on the new solution.

Don’t: Set unrealistic schedules.

However, a phased implementation only works with the right schedule behind it. Avoid your impulse to put too-short timelines behind your deployment plan at each location, or risk letting a small round of delays lead to long-term postponements as your implementation calendar goes off track.

Do: Activate staff to advocate & champion.

Every implementation consultant will tell you that having the support of experienced staff members behind your EHR initiative is critical to your ultimate success. Best practices include activating senior team leaders to learn the software as “super users” and placing both clinical and administrative staff members on the project management team (to ensure the solution meets their unique needs).

Don’t: Overload a small team.

Yet it’s important to be mindful of putting too much on your team’s plate. If your staff is overwhelmed by the responsibilities they face in advance of deployment, they’ll be all the less likely to embrace the benefits of a new solution. Make sure the folks you tap in can handle their duties without lagging on their day-to-day expectations. If necessary, bring in outside consultants to manage the most burdensome aspects of the implementation experience.

Understand Your EHR Options with NCG Medical

As an experienced medical billing provider, NCG Medical has seen just about every EHR system imaginable. We understand the pitfalls of rolling out a new system and have a proven track record for helping practices get up to speed so they can get the most out of their EHR software. Our team regularly works with the most popular EHR platforms, including:

To learn more about how our billing and coding services can help you realize the full potential of your EHR system, contact our team today so we can get started on improving your revenue cycle management.

Are you interested in learning more revenue cycle management tips? Visit our blog! 

...and if you need help from a medical billing company...


Subscribe to Our Blog

Stay in-the-know on trends, best practices, and news affecting the medical billing industry!