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Group Practices Taking The I.T. Plunge
October 2007
In late June, Robert Ashby, M.D., a solo practitioner in Scottsdale, Ariz., bought his first electronic health records system. Ashby, his medical assistant and office manager trained on July 16-17 and went live the following day.
Many forces are compelling physicians to automate their clinical documentation. Ashby, who specializes in pain management and addiction treatment, felt he could no longer ignore the force that most pressed him.
"I was getting buried in paperwork," he recalls. "I needed to get letters out to referring doctors and it wasn't getting done. I was losing patients. There would be a stack of charts for me to review and another stack of charts for the office manager to check before I got them." Now, referral letters are templated in his SpringCharts EHR from Houston-based Spring Medical Systems Inc. and finished before patients leave the office.
The force that most compelled Princeton (N.J.) Orthopaedic Associates to migrate to electronic records was the financial cost of not doing so. "We were using an awful lot of people to keep track of charts," says Rob Simpson, director of the four-site practice comprising 17 physicians and 120 staff members. "We knew what our costs were for the file room. Like any other information technology decision, it was a pretty easy decision and we have close to a one-year return on investment." The practice uses the document imaging and EHR applications of SRSsoft, Montvale, N.J.
Neither practice, however, felt pressure to go electronic from other market forces perceived to be influential. Patients weren't pushing them to automate, nor were insurers or government agencies. And both Ashby and Simpson are unaware of any hospitals in their service areas rolling out I.T. donation or subsidy programs.
"Nobody was pushing us in that direction," Simpson says. "Nobody seems particularly interested. I thought attorneys would like it, but half of them can't handle electronic media and want the chart printed and mailed to them."
In Simpson's opinion, physicians themselves are the main driving force. Practices are becoming more sophisticated at I.T. planning and recognizing the importance of building I.T. and support infrastructures, he notes. During the last three years, Princeton Orthopaedic has hired an I.T. director and support staff, and Simpson regularly hears the same story when he talks with peers.
Further, physicians are becoming accustomed to using computers at the hospital and at home, he adds.
But in some parts of the nation, the aforementioned market forces are making an impact. There are signs that the federal government's revamping of rules to permit hospitals to donate I.T. systems and services to community physicians are starting to bear fruit, says Patrick Cline, president of NextGen Healthcare Information Systems Inc., a Horsham, Pa.-based physician software vendor.
"We have noticed an up-tick in the interest level of hospitals, and we do see them having related strategies in place or developing their strategies," he notes.
The Methodist Hospital System in Houston is developing a donation program. The Department of Health and Human Services' ruling in August 2006 to permit such programs provided an impetus for the project, says Matt Fink, vice president of information technology. "We had a strategy; the rules certainly made it easier."
Donation programs are most likely to evolve in competitive regions with four or five delivery systems, Cline says. "If one hospital can turn a large cardiac practice away from another hospital, it's worth millions of dollars to do it."
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