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Friday, September 26, 2008

Incentives for Docs to go Digital

Right now, the major beneficiaries are insurers, not physicians.
By Emily Singer

Only about 15 percent of physicians in the United States are using electronic health records (EHR), a statistic that John Halamka, chief information officer and dean for technology at Harvard Medical School, aims to change.

During a panel discussion at Technology Review's EmTech conference earlier this week, Halamka outlined the major barrier in getting physicians to adopt these systems: misaligned incentives. While EHRs should ultimately reduce costs, doctors must spend $40,000 to $50,000 to buy an EHR system, and they lose 20 percent of their productivity in the first few months. And, at the end of the day, insurers and payers rather than physicians reap the rewards, Halamka said. His thoughts echo those of Karen Bell, another panelist who spoke with Technology Review.

Halamka, who is also chief information officer of the CareGroup Health System, described how his company took the digital leap: it mandated that academic affiliates, and eventually other affiliates, use EHRs. To ease the burden, Caregroup subsidized the cost of the systems and provided a training team for physicians.

Halamka will outline his prescription for broader adoption of EHRs in a letter to the incoming president, which will be published in the next issue of Technology Review.

For Halamka's perspective on Healthcare IT and beyond, check out his blog, "Life as a Healthcare CTO."

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  • Benefits of EMR
    I disagree with Mr. Halamka’s perspective regarding the lack of benefits to doctors that utilize EMR (Electronic Medical Records).  Two things specifically I will rebut. 

    First he says, “They lose 20 percent of their productivity in the first few months.”  I work for an IT Consulting firm that implements gloStream’s EMR software gloEMR.  The most recent physician practice that implemented gloEMR had the implementation completed by the end of the week, then did training on Monday after the weekend.  By the end of that week, the practice was up to a full patient load.  Granted this is probably the most successful example, but even on average, most small to mid-size practices are up to a full patient load after a couple weeks, not a few months.

    Secondly, Mr. Halamka says, “at the end of the day, insurers and payers rather than physicians reap the rewards.”  I have news for you.  No business will ever spend that much money just so their vendor can have an easier time doing its job.  Practices do not implement EMR for the sake of insurance companies.  They do it because there is a ROI for themselves.  What happens is EMR speeds the process of note taking, prescribing, referral writing, etc.  Also, it reduces errors.  In addition to that, it eliminates time wasted by chart chasing.  As a result, 20% to 40% of the practice’s time is saved.  So that hole gets filled with more patients.  In other words, the doctors spend less time doing chart work and more time seeing patients.  Plus, with accurate, built-in CPT codes, physicians are able to bill at higher levels. 

    I do not intend for this reply to be an ad, but I am using these examples because it is what I have knowledge of, and I do not think that Mr. Halamka’s blanket statements that encompass EMR software are very accurate.  Perhaps he has had a bad experience with an EMR implementation, but his grim outlook does not cover all the bases.  After implementing gloEMR, practices generally experience an increase in revenue as a result.  Sure, insurance companies receive a nice by-product due to practices implementing EMR software, but they are not the primary beneficiaries.
    Rate this comment: 12345

    DrifterKona
    10/13/2008
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