The federal government wants to give Dr. Geoffrey Drew $44,000 over five years to migrate from paper records to electronic ones.
He doesn't want it.
"It's not an incentive," he said of financial carrots and penalties used in the federal stimulus package to compel doctors, hospitals and clinics to adopt computerized patient record systems. "It's a distraction."
The stimulus package includes more than $30 billion for health information technology over six years. Much of the money will come from 2011 to 2015 in reimbursement bonuses for hospitals and doctors who make the switch. Providers who don't make the transition stand to be punished with reduced Medicare payments beginning in 2015.
The plan is designed to push healthcare into an era where patient care improves, medical errors happen less often and costs take a nosedive. Tests, prescription drugs, past illnesses and all other medical information would be kept on electronic files that may one day follow a patient from a doctor's office to a hospital or from one hospital to another. Ideally, patients would be able to check their own records to see the results of an X-ray or a blood test.
Many hospital leaders see the money as a way to ease the burden of a transition that in most places is well under way. Doctors are farther behind in the race to go electronic. Many of them are wary of the stimulus money though some see it as an opportunity to make a change that will improve their ability to care for patients.
Drew gets all that. What he doesn't get are the numbers. He thinks making the transition to an electronic records system could mean as much as $300,000 in hardware, software and staff.
"No way I'm going to pay for that," said Drew, who practices in Ventura, Calif. "You'll find very few doctors who are going to do it."
Other estimates are lower, with one suggesting doctors could pay $80,000 out of their pockets over five years.
Some observers predict electronic records will be a linchpin of healthcare reform and would generate billions in savings, partly by making care more efficient and eliminating redundancies such as X-rays taken at a clinic and then repeated in the hospital. Drew doesn't buy that math either.
"Most doctors do not see why this is such an imperative and how this would be a big money saver," he said. "We fear that this is just a further means for insurance companies to intrude on records and to spy on patients for pre-existing conditions."
Doctors say the vast majority of their colleagues, particularly those in smaller offices, push paper because they can't afford electronic medical record systems that require hardware, software and specially trained staff.
"It's very expensive not only to purchase but to maintain it," said Dr. Ted Hole, a family care doctor. He characterized electronic medical records as a good concept but one that can push doctors away from direct interaction with patients.
"We're basically becoming clerks that fill in medical records so you can get incentives from the government," he said.
Some observers think cost concerns may be diminishing. They cite reports that Wal-Mart will begin selling electronic record systems to doctors for $10,000 to $25,000. They also point to a federal law that allows hospitals to subsidize 85 percent of a doctor's software costs for electronic systems.
The threat of Medicare penalties won't force doctors into adopting the systems, said Dr. Stan Frochtzwajg, a family care doctor who plans to move from paper to electronic records. Instead, frustrated doctors might consider no longer seeing Medicare patients.
But what will push them to computerized records is the ability to easily order lab tests, exchange consultations with other doctors and write prescriptions once instead of four times, Frochtzwajg said.
"The efficiencies will be so compelling and if the costs are not so overwhelming, doctors will come on willingly," Frochtzwajg said.
(Contact Tom Kisken of the Ventura County Star in California at XX(at)xxx.com.)
Post new comment