Public clinics: EMRs good for quality, not wallet

A recent study finds that electronic medical records can help provide better care but not cost savings in community health clinics.

By Pamela Lewis Dolan, AMNews staff. Feb. 19, 2007.

More safety-net facilities are looking to electronic medical record systems as a way to provide better care for the uninsured and help save money.

But a study published in the January-February issue of Health Affairs indicates that the savings part of that goal could be a pipe dream.

The authors of the study, "The Value of Electronic Health Records in Community Health Centers: Policy Implication," interviewed six community health clinics and evaluated the benefits of each facility's EMR.

While the quality improvement benefits of an EMR are promising, the study suggests little hope for EMRs to have any financial benefit for community clinics. Revenue enhancements are nearly impossible because of Medicaid's flat-rate-per-patient payment system and the Bureau of Primary Health Care's lump-sum payment system. And while EMRs can benefit private health centers through pay-for-performance incentives, few of these incentives are offered to community clinics, the study said.

And even though the clinics might not be focused on the financial return on investment, instead focusing on improved patient care, just getting financing to start the project is a burden too great for many community clinics to bear, the study found.

Carolina Lucero, senior vice president of Sea Mar Community Health Centers, a nonprofit clinic that serves the poor and uninsured in the Seattle area, didn't have to read the study to know about the difficulties a safety-net facility faces in getting an EMR.