Doctors slow to move to electronic records

updated 7:38 p.m. ET May 23, 2005

Connie Grimstad doesn't need to call her doctor's office when she has a question about the slew of medications she takes daily — the 57-year-old homemaker simply delves into her medical records from her home computer.

With a few keystrokes, everything's there: the details of her prescriptions, health insurance records, diagnoses and surgeries.

As the medical industry moves slowly to replace its paper files with electronic versions, people like Grimstad are light years ahead of most doctors.

She's among about 10,000 Americans who've made the leap with a free online service that permits anyone to create their own electronic personal health record — and access it anywhere via the Internet.

Granted, it's far easier for consumers to go digital than it is for physicians, given the technology overhauls often involved. It took Grimstad an hour to type her medical history into her iHealthRecord account with San Francisco-based Medem Inc.

Details of her fibromyalgia, which causes chronic pain and fatigue, and Behcet's syndrome, an immune system disorder that causes ulcers and skins lesions, are password-protected and easily updated.

Before Grimstad left her Kent, Wash., home for a recent trip to California to help plan her daughter's wedding, she knew that if she had a health crisis her account could quickly bring a new doctor up to speed on her ailments. A wallet-sized emergency card has directions on accessing her iHealthRecord account.

"When you go to a new doctor, they always ask, `When did you have this and that and the other thing.' All of that's right there at their fingertips — the dates, any medications you have, everything they need," she said.

The federal government, insurers and consumer advocates are putting growing pressure on the nation's hospitals and doctors to embrace electronic health records and related technologies.

Making the switch will eliminate paperwork costs and reduce the estimated 50,000 to 100,000 deaths each year from medical errors, which include medication foul-ups resulting from poor physician penmanship.

But doctors have been slow to join the digital revolution. A Rand Corp. study published this year found that in 2002 between 10 percent and 16.4 percent of the nation's physicians had adopted electronic medical record technology.

What's holding things back isn't simply doctors set in their ways, said David Brailer, the federal government's health-information technology coordinator. Brailer, who is pushing the federal government's goal of making sure most Americans have computerized medical records within 10 years, says the cost of new technology and retraining staff is too formidable for many small practices.

But it's not just cost. Differences in technical standards and features among the software made by more than 100 software vendors hamper doctors' ability to exchange patient data with other physicians and hospitals.

The federal government is trying to change that by encouraging private industry to settle on software standards and features so the data can be easily exchanged. Federal agencies are also mulling possible incentives, such as grants, loans or tax credits, to encourage doctors to go electronic.

But until industry standards are set and software prices come down, most of the small-doctor's offices that handle about three-quarters of the nation's health care needs will be hesitant to sign on, Brailer said.

"If small-doctors' offices aren't online, patients are going to miss big chunks of their data and it frankly won't be that useful to doctors," Brailer said. "We want to have a world where the data follows the patient."

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