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Why Your Doctor May Still Have Paper Records

WebMD News from Kaiser Health News

By Eric Whitney, Colorado Public Radio

Mon, Jul 15 2013

Uncle Sam wants your doctor to go digital. And the federal government is backing up that goal by offering money to practices if they start using digital records systems.

Nearly half of all physicians in America still rely on paper records for most patient care, and time is running out to take advantage of the government incentive payments. So practices like Colorado Springs Internal Medicine are scrambling to get with the program.

Nearly 200 patients will cycle through the office on any given day. Doctors and staff pop in and out of exam rooms and offices constantly, carrying big stacks of manila folders holding patient charts. 

Just behind the front desk, Dr. Jay Kinsman stands at the practice's information nerve center. 

"There’ll be probably 500 pieces of paper come in on the fax, two times, three times a day," he chuckles.  "If that goes down we might as well close."

He is only half-joking. They have a back-up fax machine just in case.

About a year ago the practice decided it’s time to switch to an electronic health record system, or EHR, and Kinsman took charge of shopping for the right one. He quickly felt overwhelmed.

"Do we really need 250 different EHRs, and 30 fairly widely used ones and 15 really big ones?" he asks. "Could we get by with one? Would we do better with just one product?"

Actually, there’s closer to a thousand products out there. The market exploded when the federal government started offering doctors incentive payments to buy them.  The government also said that those who don’t go digital will face payment penalties in the future.

So, all across the country, doctors like Kinsman are taking sales calls. His decision will directly impact not only his and his partners’ days, but also everyone’s incomes.

He explains, "When we were starting to think about this, we were hearing dollar figures on the order of $40,000 per physician to purchase an EHR and install it, and then lost revenue in the first two or three or four months. Basically we’re planning on seeing only half as many patients a day for the first two to four weeks."

There are also decisions about computer hardware -- laptops or tablets in the exam room? Host the system on their own server, or in the cloud? Hire an IT specialist, or outsource it?  

Vexing as all that is, the practice’s business manager, Vicky Bonato, says it’s probably not even their biggest challenge.

"Having everybody have a positive attitude to do it. If we could all keep positive and just get through it and learn it, I think we’ll be OK," she says.

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