Doctors slow to move to electronic records

When that day comes, patients who want a second opinion will have a much easier time arranging one, said David C. Kibbe, director of the American Academy of Family Physicians' center for health-information technology. Currently, getting a second opinion means collecting records from several physicians, radiology offices and labs.

Kibbe said a recent survey of the academy's 105,000 members found that more about 15 percent currently use electronic health records. Another 30 percent to 40 percent are "looking very seriously" at joining them in the next few years, he said.

WellPoint Inc., the nation's largest health benefits provider, last year enticed 25,000 of its high-volume physicians in California, Georgia, Missouri and Wisconsin with a choice of either free computers to submit claims electronically or PDAs for writing e-prescriptions that eliminate doctor's notoriously sloppy handwriting.

For a host of reasons, about a quarter of the physicians passed up the $42 million offer. Among the 19,600 who bit on it, only 2,700 chose the PDAs, Dell Axims that run on Microsoft software, said Carl Volpe, vice president of strategic initiatives for WellPoint's health solutions division.

Although the company had hoped more of the doctors would have chosen PDAs to help reduce medical errors, Volpe said WellPoint realizes that adopting new technology is a big step for any business.

"When you talk to physicians about new technology, the common discussion right now is how does the new technology fit into their existing work flow?" he said. "They want to know how their work flow will change."

Dr. Jim Morrow, one of eight doctors and eight physician assistants with a three-office family practice in suburban Atlanta, said he and his colleagues switched to electronic health records in 1998 at a cost of $150,000 for computers and software.

For the first few weeks, things were a bit chaotic, he said, because it took longer to examine each patient while the staff adjusted to typing notes and prescriptions into computers, instead of scribbling things down.

But the change more than paid for itself in the first year, Morrow said, through $225,000 in savings that came largely from eliminating the costs of transcribing notes after patients' examinations and adding them to their growing paper files.

Going digital also increased the speed and size of insurance reimbursements, he said, because insurers now receive more detailed accounts of patients' progress and they get them more quickly with electronic submissions.

Morrow said he would never go back to paper files.

Among other things, he and his colleagues can keep closer track of his patients' treatment because the practice's system has prompts when it's time for patients to get annual tests such as mammograms or prostate exams. The practice's 59,000 patient files are also linked to a database that warns when a doctor writing prescriptions is prescribing a potentially dangerous drug combination.

"I'm a much better physician because of it," Morrow said.

While he's riding the new technology wave, his old medical school classmate, Dr. Ralph Riley, is sticking with paper records for now.

Riley works nine to 10 hours a day seeing more than 100 patients at his practice in rural Saluda, S.C., with the help of a nurse practitioner and physician's assistant.

He recognizes the benefits of electronic health records, but said the cost, lack of uniformity among software and the disruption of switching from paper to electronic records would be too daunting for him right now.

"Getting to electronic medical records is like going to paradise, but you have to walk through a bed of hot coals to get there. I want to get there — I just don't want to get my feet burned on the way," he said.

Consumer advocates have their own worries.

Emily Stewart, an analyst for the nonprofit Health Privacy Project in Washington, D.C., said security and privacy issues posed by digital medical records have not been adequately addressed.

"Consumers are the biggest stakeholders here, and the success of any national health network will ultimately depend on their trust and participation," Stewart said.

Edward Fotsch, the chief executive of Medem Inc., said his company's fledgling iHealthRecord system protects patients' date with encrypted security features modeled after those adopted by the financial-services industry.

He believes Medem, a nonprofit founded in 1999 by the American Medical Association and six other medical societies, can help win over patients who will then encourage their doctors to make the switch from paper to digital records.

About 100,000 doctors who subscribe to Medem's Web site and doctor-patient e-mail services are now linked to its iHealthRecord service, he said.

Aside from tying their records into one online package, participating patients are kept abreast of the latest medical research and are quickly notified by e-mail when the U.S. Food and Drug Administration pulls a drug they are prescribed.

"It's a personal health record but it's really interactive. It reaches out to you and tells you things you need to know," Fotsch said.

MORE FROM MORE HEALTH NEWS

More Health News Section Front

Bits of steel, rubber found in Genzyme drugs FDA tackles drug marketing on social media Chimp attack victim reveals face on Oprah Pfizer drug studies fudged, report says Antibiotic overuse could threaten medicine Using human DNA in animals? UK to study Calif. medical pot shops abound, despite order Scientists halt brain disease with gene therapy FDA launches plan to curb accidental overdoses Maryland will monitor doctors’ hand washing More Health News Section Front   Add More Health News headlines to your news reader: