A Slow Switch to Electronic Health Records
Only 4% of U.S. Doctors Use Fully Functional Electronic Systems
June 18, 2008 -- Less than one in 20 American doctors is using fully functional electronic health records and e-prescribing systems in their offices. And researchers say that figure shows that the switch to the new technology is moving too slowly.
Many experts say that computerized health records reduce medical errors and improve doctors' ability to communicate with patients and keep up with their care.
Government agencies for years have been pushing physicians and hospitals to adopt the systems but have met resistance, especially from small and medium-sized medical practices.
Just 4% of doctors nationwide are now using fully functional electronic systems that let them write and send computerized orders, view lab results, keep medical records, and provide alerts if a prescription poses a risk of an allergy or adverse drug reaction. That's according to a survey of nearly 2,800 physicians published online by the New England Journal of Medicine.
Thirteen percent are using more limited versions of electronic records or prescribing programs, it concludes.
"We know that adoption is moving along slowly," says Catherine DesRoches, PhD, a health policy researcher at Massachusetts General Hospital in Boston and study researcher.
President Bush has called for widespread use of electronic health records and other information technology by the end of 2013.
"Clearly, the results show that we're a long way from adoption by 2013," DesRoches says.
Main Barrier: Cost
Large group practices are much more likely than small ones to use the systems, the study concludes. One big reason is cost, which can mount to $50,000 or more just to get off the ground with an electronic system to install.
"It cost us over $40,000 per doctor," says Richard Baron, MD, who heads Greenhouse Internists, a five-doctor Philadelphia practice that installed a full electronic health records system in 2004.
Baron says switching to the system caused an upheaval in his practice and even cost the office more than 2% of its revenue at first. But he also said the system offers a major advantage now that it's up and running.
Baron says test results are routinely delivered to patients via email within 24 hours and that computer tracking allows doctors, nurses, and aides to flag chronic disease patients who are overdue for appointments.
"You no longer need to be a medical genius to access the information in the chart," he says.
Health and Human Services Secretary Michael O. Leavitt last week announced a program that would steer $150 million to 12 cities to help small and medium-sized practices acquire electronic systems. The demonstration could also pay bonuses to offices that use the systems to report quality information.
The project is part of an effort to stoke lagging uptake of the systems among American physicians.
Ask Your Doctor
But David Blumenthal, MD, who heads the Institute for Health Policy at Massachusetts General Hospital, says patients can also help drive their doctors to make investments in the systems. The survey showed that more than 40% of doctors' offices have plans to buy electronic systems or had already purchased but had not started using it at the time of the survey.
"I think asking about them might be the first thing," says Blumenthal, who is also an advisor to Sen. Barack Obama's presidential campaign.
"I think patients coming in to doctors and saying, 'Hey, how come you don't have this' could be very powerful," Baron says.
Today's study is part of a larger report on the state of health information technology due to be released in July.