This year, the AAOS released two practice managmenet primers—an updated Electronic Medical Records primer (left) and a new primer on Hospital Employment of Orthopaedic Surgeons.


Published 9/1/2010
Steven E. Fisher, MBA

EMR Primer: The next generation

Free primer helps you adopt the latest technology

According to the National Center for Health Statistics, just 6 percent of U.S. office-based physicians were using a fully functioning electronic medical records (EMR) system in 2009. Even if the adoption rate among orthopaedists is three times greater than the physician population as a whole, approximately 80 percent of AAOS members are not using a fully functioning EMR system.

New technology purchases are always difficult. The capital expense required for a new magnetic resonance imager or operating room table is substantial. But these are technologies that orthopaedic surgeons are accustomed to using. Spending thousands on a new technology that you don’t know how to use is a daunting thought.

That’s one reason the AAOS introduced its first primer on electronic medical records in 2007—to provide basic information and decision assistance to orthopaedic surgeons just beginning to investigate this new world of EMRs. But the stakes are higher now than they were in 2007—and so the AAOS has revisited the issue of EMRs.

The federal carrot-and-stick
The Health Information Technology for Economic and Clinical Health (HITECH) Act (part of the 2009 American Recovery and Reinvestment Act) provides for annual incentives to be paid to physicians who make “meaningful use” of EMRs starting next year (2011). The earlier a physician successfully implements an EMR system, the more money he or she can receive—up to a maximum of $44,000 through the year 2015.

In 2015, however, the Centers for Medicare & Medicaid Services (CMS) plans to reduce Medicare payments by 1 percent for physicians who do not use EMRs, and private payors may very well follow suit. Penalties may increase in future years. No wonder 58 percent of all physicians who do not currently have an EMR system intend to purchase one within the next 2 years. Among younger physicians (those younger than age 55), 80 percent plan to adopt EMRs.

This year, the AAOS released two practice managmenet primers—an updated Electronic Medical Records primer (left) and a new primer on Hospital Employment of Orthopaedic Surgeons.

Mastering the mystery of EMRs
The original EMR primer is still available online and includes valuable information—including a list of questions to ask EMR vendors during demonstrations; the second edition, written specifically from the standpoint of the practicing orthopaedic surgeon, provides a thorough review of what goes into an EMR system and how to get the most out of one.

Written by the members of the AAOS Electronic Health Records Project Team—all of whom currently use EMRs and know the dramatic changes that EMR adoption can make in an orthopaedic practice, the second edition covers the advantages and efficiencies of a correctly installed EMR system and provides possible strategies for dealing with barriers to acquisition, implementation, and adoption of EMRs.

“Our project team strongly believes the adoption of EMR systems will benefit the medical profession and specifically orthopaedic surgeons,” says Chairman Thomas C. Barber, MD. “Although the cost of purchasing an EMR system is substantial, the price tag for private practices is dropping and software features are improving. The benefits outweigh the costs, and we encourage AAOS members to adopt EMRs if they have not done so already.”

Steven E. Fisher, MBA, is manager of the Practice Management Group at the AAOS. He can be reached at or (847) 384-4331.

Primers enhance orthopaedic practice
The AAOS has the following primers designed to help AAOS members enhance their orthopaedic practices:

  • Electronic Medical Records (2007 and 2010)
  • Picture Archive and Communication Systems (2008)
  • Human Resources Management (2009)
  • Hospital Employment for Orthopaedic Surgeons (2010)

All primers are available in electronic form on the Academy’s Web site and can be downloaded for free. The next primer, on improving a practice’s financial performance, is scheduled for release during the 2011 Annual Meeting.