Electronic health care records used in only 9% of small practices Posted by: McQ
on Thursday, June 19, 2008
As mentioned the other day, electronic medical records are touted by the Obama campaign as a major part ($77 billion) of the $120 billion savings ($2,500 per family) his health care plan would bring. FactCheck.org did a good job of exposing the fact that few if any experts expect electronic records to be on line before 2019.
But why is that the case? The New York Times highlights a report in the NEJM that gets into the particulars:
The report, published online on Wednesday in The New England Journal of Medicine, found that doctors who use electronic health records say overwhelmingly that such records have helped improve the quality and timeliness of care. Yet fewer than one in five of the nation’s doctors has started using such records.
Bringing patient records into the computer age, experts say, is crucial to improving care, reducing errors and containing costs in the American health care system. The slow adoption of the technology is mainly economic. Most doctors in private practice, especially those in small practices, lack the financial incentive to invest in computerized records.
The national survey found that electronic records were used in less than 9 percent of small offices with one to three doctors, where nearly half of the country’s doctors practice medicine.
Cost and the suitability of existing software are the major factors according to the story.
Dr. Paul Feldan, one of three doctors in a primary care practice in Mount Laurel, N.J., considered investing in electronic health records, and decided against it. The initial cost of upgrading the office’s personal computers, buying new software and obtaining technical support to make the shift would be $15,000 to $20,000 a doctor, he estimated. Then, during the time-consuming conversion from paper to computer records, the practice would be able to see far fewer patients, perhaps doubling the cost.
“Certainly, the idea of electronic records is terrific,” Dr. Feldan said. “But if we don’t see patients, we don’t get paid. The economics of it just seem so daunting.”
Dr. Brailer also pointed to the 54 percent of doctors without electronic health records who said that not finding an electronic health record that met their needs was a “major barrier” to adoption. In short, they are not satisfied with the existing products, which tend to be designed for hospitals — big customers — instead of small practices.
“What we see is a deficit in innovation, and that is something innovators and the capital markets can address,” said Dr. Brailer, who leads a firm that invests in medical ventures, Health Evolution Partners.
Brailer mentions the key - innovators and the market must address this need that, at the moment, excludes 54% of doctors, and make it cost effective to make the change.
Naturally the government will move to preempt the market and, apparently, hope that existing software will fit all needs:
The government took a step in that direction last week, announcing a $150 million Medicare project that will offer doctors incentives to move from paper to electronic patient records. The program is intended to help up to 1,200 small practices in 12 cities and states make the conversion.
Individual doctors will be offered up to $58,000 over the five-year span of the project, which is intended to test the impact of incentives on the spread of electronic health records. Further programs across the country are planned.
Given the huge and costly failure endured by the taxpayers when the IRS tried to upgrade its software, I can only hope that the market is left to do the work necessary to provide the product necessary for smaller practices and the integration necessary to make it all work.
Last but not least, this is not an innovation thought of or initiated by the Obama campaign. This is an idea that campaign has adopted because they think it makes their health care numbers look better. Remember to deduct that $77 billion from whatever total savings Obama and his crew are throwing around at campaign events. It's not going to happen even if, heaven forbid, he was to be there for 2 terms.
The idea behind electronic health records is to have a computer-based history of a patient’s clinical and administrative details. This will include every document made by each doctor that was ever involved with the patient’s medical history.The issue with all computerized systems is security. Software developers in the EMR industry are taking steps to improve security by adding features like username and password requirements.