Most Wired

Another Way to Seal The Deal

As competition for physicians heats up, EMRs and other technology help hospitals stand out

When Alabama’s Cullman Regional Medical Center completed its nationwide search for a new physician group to take over its emergency room, its top choice presented a make-or-break demand: replace the department’s antiquated paper charts with a modern electronic medical record. For Neil Schamban, M.D., head of the group and now Cullman’s chairman of emergency medicine, an EMR is as essential as a stethoscope or blood pressure cuff. “If you want to deliver the best care, you can’t do that without a good EMR,” he says.

No stranger to technology in its other departments, Cullman realized it couldn’t attract the physician expertise it sought without the right IT portfolio. “Cullman, Ala., is a nice place, but it’s not the big city where some of these doctors are from,” says Jete Edmisson, chief financial and chief operating officer. “So we had to show we were willing to provide systems that are in harmony with what they’ve trained on. [New recruits] want to make sure that they’re not teleporting back to the ’70s.”

Once a source of physician angst and some famous walkouts, clinical information technologies are fast becoming the focus of recruiting efforts at many hospitals and their associated physician practices. Although some wired docs may be gadget addicts, most seek more practical benefits from technology. “Twenty years ago, location, location, location was the key to recruitment,” says Kurt Mosley, senior vice president of business development for Merritt Hawkins & Associates, a physician staffing agency. “Now it’s lifestyle, lifestyle, lifestyle.” 

EMRs, physician portals and other digital innovations enhance physicians’ lives by helping them work more efficiently and access medical records from home, which helps them avoid off-hour return trips to hospitals, he says.

Hospitals across the country are coming to the same conclusion. Community Health Network, Indianapolis, recently attracted a new hospitalist on the strength of its EMR. “When he was considering relocating from Atlanta, he requested a discussion with me to talk about our technology,” says Edward Koschka, network vice president and CIO. “[Technology] is top of mind with folks that are moving from state-of-the-art hospitals.”

MemorialCare Medical Centers, Long Beach, Calif., runs a network of several community hospitals with associated offices of community practitioners. It sees IT as a key tool in the competition for physician talent with California’s Kaiser Permanente health system, which attracts large numbers of new physicians each year. “We feel we have to do everything we can to attract physicians to our environment, as everyone is forecasting a shortage of physicians,” says Scott Joslyn, senior vice president and CIO.

Technology ‘Must Haves’

When it comes to technologies with physician appeal, hospitals and recruiters say four solutions stand out:

• EMRs: Recruiter Mosley calls them “almost a must” for attracting physicians, especially doctors who specialize in emergency care. “Emergency department doctors tell us it’s very frustrating to them [to face] being sued for treating patients incorrectly, but they don’t have accurate [paper] medical records,” he says.
   
• Physician portals: These convenient interfaces allow physicians to log in to the EMR from outside the hospital when questions come up or to enter new care orders after hours.
  
• Digital imaging and picture archiving and communication systems: “I just can’t imagine trying to live in a world where we’re still based on film rather than digital images,” says Michael Venturini, M.D., chief medical information officer at the Indiana Heart Hospital, an all-digital facility that’s part of the Community Health System. “Not only can I look at an image digitally, I can look at the associated report anywhere, anytime.”
  
• Nonclinical medical services applications: Hospitals that install systems for billing, purchasing and other administrative functions reduce the cost and drudgery of activities that can sap physician time. “We can lower their cost of operation, allow them to practice medicine, and otherwise be an independent practitioner that can set their own hours and lifestyle,” Joslyn says.

He adds that adopting these technologies to cement physician loyalty has gotten easier with the recent relaxation of antikickback rules. The changes “allow us, absent any explicit quid pro quo, to subsidize the physicians’ purchase and use of electronic medical record systems up to as much as 85 percent of eligible cost,” Joslyn explains. In many cases, that amount covers much of the up-front costs for launching the applications. “We can get [physician offices] over the threshold of a capital outlay and get up and running.” The hope is that EMR efficiencies then balance the ongoing monthly costs that practices pay to tap into the hospital-managed EMR solution.

Beyond Technology to Training

Hospitals that leap to install the latest and greatest products aren’t guaranteed an edge in the recruiting game, executives warn. “If there’s a takeaway from our experience over six years, it’s to always apply the technology to make a process better,” says Venturini. “Don’t think a process will get better because you’re throwing technology at it.”

Extensive training is one way to protect the investment. Before construction was completed at the Indiana Heart Hospital, the organization rented trailers to house simulated diagnostic and catheterization laboratories and patient rooms. “The regular medical staff [had to log] six hours of training before they could have privileges here,” Venturini says. “As we brought on new people, we’ve required a similar amount of IT training.”

Merritt Hawkins’ Mosley sees another trend that’s helping to attract physicians to practices associated with technology-savvy hospitals. Preceptors are being appointed to familiarize new recruits with EMRs and other technologies.

“The smart hospitals are saying, ‘This doctor is good. He wants to come into your practice. We will take care of all the training with the EMR,’” Mosley says. For now, preceptors work in only about 15 percent to 20 percent of hospitals, he adds, but calls this group “the hospitals on the cutting edge.”—Alan Joch is a freelance writer in New Hampshire.

This article 1st appeared in the April 2009 issue of HHN Magazine.

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